Christoph Lutter
C V Path Institute, USA
Title: Rock climbing related bone marrow edema of the hand: A follow up study
Biography
Biography: Christoph Lutter
Abstract
Objective: Sport climbers strain passive and active anatomical structures of their hands and fingers to the maximum during training or competition. This study was designed to investigate bone marrow edema in rock climbing athletes.
Design: Systematic detection, treatment and follow-up investigation of rock climbing athletes with bone marrow edema of the hand.
Setting: Primary-level orthopedic surgery and sports medicine division of a large academic medical center.
Patients: Thirty-one high-level climbers with diffuse pain in the hand and wrist joint caused by rock climbing were included in this study.
Interventions: The therapy consisted of consequent stress reduction and break from sporty activity.
Main outcome measures: Reduction of bone marrow edema in MRI and regain of pre-injury climbing level (UIAA metric scale).
Results: In 28 patients, the MRI revealed osseous edema due to overload at the respective area of interest, mainly in the distal radius, the distal ulna or the carpal bones, which could not be identified otherwise diagnosed as inflammations, tumors or injuries. We classified these edemas and fractures of hamate as due to overload. The edema resulted as a stress reaction to highly intensive training and climbing, with presumably high traction to the wrist area. The control MRIs demonstrated that - even with a consequent stress reduction - these edemas need three to four months to disappear completely.
Conclusion: Climbers with an unspecific, diffuse pain in the wrist and/or the fingers should be examined with MRI to detect or exclude the diagnosis of a bone marrow edema (BME).