2019 ISAKOS Biennial Congress ePoster #505

Two-Year Follow-Up Study of Subchondral Surface Irregularities of the Capitellum on Ultrasonography in Baseball Players Under the Age of 10 Years

Toshiyuki Iwame, MD, Tokushima JAPAN
Tetsuya Matsuura, MD, PhD, Tokushima JAPAN
Naoto Suzue, MD, PhD, Komatsushima, Tokushima JAPAN
Koichi Sairyo, MD, PhD, Kawasaki, Kanagawa JAPAN
Tokushima University, Tokushima, JAPAN

FDA Status Not Applicable

Summary

We followed up subchondral surface irregularities of the capitellum on ultrasonography in baseball players under the age of 10 years in 2 years, and our results suggested that subchondral bone surface irregularities of the capitellum on ultrasonography in children under the age of 10 years might not be indicative of disease, but rather represent variation of ossification during normal development.

Abstract

Background

Improvements of ultrasonography have allowed more detailed cross-sectional images of osteochondritis dissecans (OCD) of the capitellum to be obtained. In a previous report, the most irregularities at the subshondral surface aged 10-12 years are variations of ossification during normal development. However, irregularities at the subchondral bone surface in individuals 9 years of age or younger may still represent early OCD.

Objective

To determine whether subchondral surface irregularities of the capitellum on ultrasonography in baseball players under the age of 10 years are indicative of early OCD of the capitellum.

Materials And Methods

A total of 321 players aged 6–9 years underwent ultrasonographic examination, and the findings for the subchondral bone of the capitellum on the throwing side were graded as 0, 1a, 1b, 2, or 3 (0, normal; 1a, irregularities at the subchondral bone surface; 1b, a cystic lesion of the subchondral bone surface; 2, irregularity of the subchondral bone; 3, discontinuity of the subchondral bone). Subjects classified as grade 1a or 1b showed irregularities of the subchondral bone surface and were investigated radiographically for OCD. All players continued to throw and were re-examined by ultrasonography after 1 and 2 years.

Results

At the first examination, 11/321 (3.4%) had irregularities at the subchondral surface of the capitellum (grade 1a in 7/321 [2.2%], grade 1b in 4/321 [1.2%]). The 7 players with grade 1a showed no evidence of OCD or Panner’s disease on radiography and were reclassified as grade 0 at the 2-year follow-up. All 4 players with grade 1b were reclassified as grade 0 at follow-up 1 and 2 years later.

Conclusion

Subchondral bone surface irregularities of the capitellum on ultrasonography in children under the age of 10 years may not be indicative of disease, but rather represent variation of ossification during normal development.

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