Allbery Sandra,  Powers Andria,  Love Terri,  Wheelock Lisa

Final Pr. ID: Poster #: CR-032

We present a case of an 18YO male high school baseball player with acute onset posterior pain in his non-throwing left shoulder, the leading shoulder in his batting swing. Pain began on a missed attempt at hitting an outside pitch. The pain only occurred when he was batting and resulted in subsequent loss of batting power and accuracy. Patient was asymptomatic when he was not batting. Prior to the acute event, patient had low grade pain in this location during intermittent at bats. Physical exam showed 1-2+ left shoulder posterior instability and mildly asymmetric left less than right shoulder strength. He had negative Neer, Whipple, Speed’s, and Hawkin’s tests. MRI left shoulder showed posterior labral tear with paralabral cyst. Patient underwent laparoscopic posterior labral repair with placement of four anchoring sutures and Bankart reconstruction. He did well post-operatively, returning to preinjury strength and range of motion in four months and returning to play in 6 months.
Batter’s shoulder is a rare condition recently recognized in the orthopedic literature and has not been reported to our knowledge in the radiologic literature. Although the adolescent/young adult spectrum of shoulder injuries in the throwing arm have been well described, injury types and mechanisms involving the non-throwing arm are not commonly known. The mechanics of hitting places considerable stress on the leading shoulder. Biomechanics studies by Welch CM et al show that as the hitter slides forward, the force applied by the front foot equals 123% of body weight and the hip segment rotates to a maximum speed of 714 degrees/second. This is followed by maximum shoulder segment velocity of 937 degrees/second and maximum linear bat velocity of 31 m/second. During a missed pitch, these forces are magnified due to lack of a counterforce against the dynamic posterior pulling force on the lead shoulder. Athletes with labral tear of the leading shoulder during batting (Batter’s shoulder) have a better prognosis than throwing arm labral tear, with approximately 90% returning to previous level of play.
This exhibit will display biomechanics, pre-operative and post-operative MRIs, and intra-operative laparoscopic images of Batter’s Shoulder. Read More

Authors:  Allbery Sandra , Powers Andria , Love Terri , Wheelock Lisa

Keywords:  Hitter's shoulder, Posterior labral tear, Posterior shoulder instability, Arthroscopy, Batter's shoulder

Salman Rida,  Kan J.,  Jadhav Siddharth,  Schallert Erica,  Ditzler Matthew

Final Pr. ID: Poster #: EDU-055

To illustrate the discrepancies between knee MRI reports and arthroscopy findings of posterior horn medial meniscal and meniscocapsular tears (ramp lesions) in children and adolescents. We retrospectively reviewed the available data from 912 patients between January 2018 and October 2022 from multidisciplinary monthly arthroscopic-MR correlation conferences, where we discussed discrepant findings between MRI knee reports and intra-operative arthroscopy findings, with focus on presence, location and type of posterior horn medial meniscal and posterior meniscocapsular tears. Results of secondary reviews of the MRI scans regarding under or over called diagnoses based on an arthroscopic reference standard were also available.
By sharing our experience and the lessons we have learned from these multidisciplinary conferences, we highlight the challenges that radiologists might face while diagnosing pediatric meniscal tears on MRI. Read More

Authors:  Salman Rida , Kan J. , Jadhav Siddharth , Schallert Erica , Ditzler Matthew

Keywords:  Meniscal tear, ramp, arthroscopy