Diagnostik von Überlastungsschäden bei Sportkletterern

ZusammenfassungSportklettern zeigt eine zunehmende Popularität sowohl im Elitesport als auch im leistungsorientierten Breiten- und Schulsport. Dadurch kommt klettertypischen Beschwerden eine zunehmende medizinische Bedeutung zu. Bei dieser Sportart stehen Überlastungen (“overuse”) hauptsächlich im Bereich der oberen Extremität an erster Stelle der Beschwerden. Neben der klinischen Untersuchung, welche in der Akutphase limitiert sein kann, ist die bildgebende Diagnostik zur exakten Abklärung notwendig, um ein adäquates therapeutisches Management zu gewährleisten. Im Rahmen dieser Arbeit wird ein Überblick über den Einsatz der unterschiedlichen Bildgebungsmodalitäten wie konventionelles Röntgen, Ultraschall und Magnetresonanztomographie bei den klettertypischen Beschwerdebildern gegeben.AbstractSport climbing shows an enormous increase in participation, evolving to more popularity, including even school sport activity on high standards. Therefore the number of climbing related injuries is increasing and becomes a more frequently encountered medical problem. Typical climbing associated injuries involve predominantly the upper limb. Overuse injuries are the most common climbing related injuries.The clinical examination is the first line investigation, which is often limited especially in the acute phase. However, an exact diagnosis is desireable for therapeutic management. Imaging modalities have shown to be capable for detection of climbing related injuries. An overview about the current use of x-ray, ultrasound and magnetic resonance imaging in different climbing related overuse injuries is presented.

[1]  L. Lantieri,et al.  Diagnosis of digital pulley rupture by computed tomography. , 1996, The Journal of hand surgery.

[2]  W. Grechenig,et al.  Sonoanatomie und -pathologie des Ellbogengelenks beim Kind und beim Erwachsenen , 1998, Der Radiologe.

[3]  D Resnick,et al.  Pulley system in the fingers: normal anatomy and simulated lesions in cadavers at MR imaging, CT, and US with and without contrast material distention of the tendon sheath. , 2000, Radiology.

[4]  H. Bonel,et al.  Imaging in sports medicine: hand and wrist. , 1997, European journal of radiology.

[5]  S R Bollen,et al.  Hand injuries in competition climbers. , 1990, British journal of sports medicine.

[6]  Ferdinand Frauscher,et al.  Finger Injuries in Extreme Rock Climbers , 1999, The American journal of sports medicine.

[7]  C. Hayes,et al.  Sonographic evaluation of the median nerve at the wrist. , 2001, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[8]  J T Rohrbough,et al.  Radiographic osteoarthritis in the hands of rock climbers. , 1998, American journal of orthopedics.

[9]  W. H. Bowers,et al.  Closed traumatic rupture of finger flexor pulleys. , 1994, The Journal of hand surgery.

[10]  M. Valle,et al.  US of nerve entrapments in osteofibrous tunnels of the upper and lower limbs. , 2000, Radiographics : a review publication of the Radiological Society of North America, Inc.

[11]  Michael D. Rooks,et al.  Injury Patterns in Recreational Rock Climbers , 1995, The American journal of sports medicine.

[12]  H. Pavlov,et al.  Sports injury update: imaging features. , 2001, Current problems in diagnostic radiology.

[13]  Martin Lutz,et al.  Disruption of the Finger Flexor Pulley System in Elite Rock Climbers , 1998, The American journal of sports medicine.

[14]  P Peters,et al.  Orthopedic problems in sport climbing , 2001, Wilderness & environmental medicine.

[15]  G. Bodner,et al.  Diagnosis of digital flexor tendon annular pulley disruption: comparison of high frequency ultrasound and MRI. , 1999, Ultraschall in der Medizin.

[16]  A. Dilley,et al.  The use of cross-correlation analysis between high-frequency ultrasound images to measure longitudinal median nerve movement. , 2001, Ultrasound in medicine & biology.

[17]  W D Middleton,et al.  Sonography of the hand and wrist. , 2000, Seminars in ultrasound, CT, and MR.

[18]  J T Rohrbough,et al.  Overuse injuries in the elite rock climber. , 2000, Medicine and science in sports and exercise.

[19]  C. Martinoli,et al.  Sonographic evaluation of digital annular pulley tears , 2000, Skeletal Radiology.

[20]  J. Drapé,et al.  Acute trauma of the extensor hood of the metacarpophalangeal joint: MR imaging evaluation. , 1994, Radiology.

[21]  Stefano Bianchi,et al.  Ultrasound of tendons and nerves , 2001, European Radiology.

[22]  P Peters,et al.  Nerve Compression Syndromes in Sport Climbers , 2001, International journal of sports medicine.

[23]  T D Noakes,et al.  Elbow, forearm, wrist, and hand injuries among sport rock climbers. , 1996, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[24]  Tait S. Smith,et al.  Pathomechanics of Closed Rupture of the Flexor Tendon Pulleys in Rock Climbers* , 1998, The Journal of bone and joint surgery. American volume.

[25]  R. Fritz MR Imaging in Sports Medicine: The Elbow , 1997 .

[26]  M. Hall-Craggs,et al.  The Use of Ultrasound Imaging to Demonstrate Reduced Movement of the Median Nerve during Wrist Flexion in Patients with Non-Specific Arm Pain , 2001, Journal of hand surgery.

[27]  K. Shea,et al.  Manual demands and consequences of rock climbing. , 1992, The Journal of hand surgery.

[28]  W. Pförringer,et al.  Verletzungen und Überlastungssyndrome beim extremen Sportklettern , 1998 .

[29]  S R Bollen,et al.  Radiographic changes in the hands of rock climbers. , 1994, British journal of sports medicine.

[30]  F. Pugliese,et al.  Ultrasound of the elbow , 2001, Skeletal Radiology.

[31]  W. F. Conway,et al.  Bowstring injury of the flexor tendon pulley system: MR imaging. , 1996, AJR. American journal of roentgenology.

[32]  T. Cabada,et al.  Carpal tunnel syndrome: usefulness of sonography , 2000, European Radiology.

[33]  Dieter zur Nedden,et al.  Finger pulley injuries in extreme rock climbers: depiction with dynamic US. , 2002, Radiology.

[34]  M. Schocke,et al.  [Value of high-resolution ultrasound in the evaluation of finger injuries in extreme sport climbers]. , 2000, Ultraschall in der Medizin.