little league shoulder
School ager
baseball player with shoulder pain. AP radiograph of the shoulder shows widening of the lateral aspect of the physis.The diagnosis was Little Leaguer’s shoulder.
Little league shoulder is thought to occur due to overuse damage of the proximal humeral epiphysis/metaphysis, seen typically in young baseball players, especially pitchers.
Epidemiology
Although it is most commonly seen in baseball players particularly in pitchers, it also presents in adolescents playing cricket and volleyball, swimmers and gymnasts.
Clinical presentation
Clinical presentation is most commonly manifested as shoulder pain.
Pathology
Little league shoulder patients commonly demonstrate delayed epiphyseal closure and physeal broadening leading to an acute transphyseal break in the bone. The pathogenic process is exacerbated by repetitive overhead ball throwing.
Radiological features
Plain radiograph
- widening of the proximal humeral physis
- sclerosis and fragmentation of adjacent bone
- demineralization of bones
Treatment and prognosis
Treatment consists of counseling, rest and physiotherapy.
It seldom requires surgical intervention.
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