Presentation
Patient presented to ER with left fifth digit swelling following Hockey injury.
Patient Data
There is mild widening of the distal radial physis with associated sclerosis and minimal irregularity of the metaphysis.
Mildly displaced Salter-Harris type II fracture of the distal phalanx of fifth digit with mild swelling of the overlying soft tissue.
There is mild irregularity of the growth plate of the mid phalanx, probably represents a sequel of an old traumatic injury.
Zoomed views of the wrist demonstrate the widening of the radial physis and the metaphyseal sclerosis.
Case Discussion
This is a case of mild gymnast wrist injury in a hockey player. Distal radial physeal injury (Salter-Harris type I fracture) is common in gymnasts, secondary to the wrist overuse. However, it occasionally affects other athletes. Radiographically, it manifests as widening and irregularity of the growth plate of the distal radius with/without associated metaphyseal and epiphyseal sclerosis. MRI is superior to plain radiography and can detect ligamentous injury and edema within the physis, metaphysis and epiphysis before the findings become visible on plain radiography. Because early diagnosis can potentially prevent further damage of the physis, it can be considered in individuals at high risk like professional gymnasts.
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