Symptomatic stress reaction of the humerus in a professional cricketer

Abstract

A symptomatic bone stress reaction is an early pathological feature, which can lead to stress fractures. It typically affects bones of the lower limbs in response to unaccustomed disproportional compressive loading. Professional sportspeople are susceptible to both bone stress reaction and stress fractures, where training regimes and competition predispose to overuse injuries. We discuss a unique case of a professional cricketer developing pain in the throwing arm due to bone stress reaction in the distal humerus, as confirmed on MRI. Modification of the patient's training regime, presented in this case, facilitated complete recovery within 6 weeks. The positive response to modified training suggests a biomechanical origin of the pain. This case illustrates that tensile stress associated with throwing activities can result in a symptomatic bone stress reaction of the humerus in elite cricketers.

Keywords: musculoskeletal and joint disorders; physiotherapy (sports medicine); radiology; sports and exercise medicine.

Figure 1

(A–D) Serial coronal MRI images of the right distal humerus. (E) Sagittal MRI image of the right humerus. (F) Axial MRI image of the distal humerus. *Denotes significant bone marrow oedema.