Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb 16;4(2):e487-e493.
doi: 10.1016/j.asmr.2021.10.029. eCollection 2022 Apr.

Magnetic Resonance Imaging Findings of the Asymptomatic Shoulder May Impact Performance, Not Future Injury List Placement in Major League Baseball Pitchers

Alexander Beletsky  1 , Kelechi R Okoroha  2 , Brandon Cabarcas  2 , Grant H Garcia  2 , Anirudh K Gowd  2 , John Meyer  2 , Amar S Vadhera  2 , Harsh Singh  2 , Safa Gursoy  2 , Gregory M White  2 , James Davidson  3 , Gregory P Nicholson  2 , Jorge Chahla  2 , Nikhil N Verma  2
Affiliations

Magnetic Resonance Imaging Findings of the Asymptomatic Shoulder May Impact Performance, Not Future Injury List Placement in Major League Baseball Pitchers

Alexander Beletsky et al. Arthrosc Sports Med Rehabil. .

Abstract

Purpose: To evaluate preseason shoulder magnetic resonance images (MRIs) obtained from pitchers entering either major or minor league baseball (MLB) and correlate findings with subsequent injury, operative repair, and placement on the injured list (IL).

Methods: Preseason-MRI of the throwing shoulders of professional-level baseball pitchers, taken during routine evaluations at a single organization (2004-2017) were retrospectively reviewed. Publicly available databases were queried to exclude pitchers with known injuries prior to pre-signing imaging. Three blinded reviewers reviewed all MRI scans independently to evaluate for the presence of abnormalities in the rotator cuff (RTC), labrum, capsule, long-head of the biceps tendon (LHBT), and humeral head. Binary imaging findings were correlated to future placement on the IL for subsequent shoulder complaints. Bivariate statistics using Student's t-tests and Fisher exact tests (both α = .05) were used in this study.

Results: A total of 38 asymptomatic pitchers with shoulder MRIs were included. Pitchers had a mean (±SD) age of 28.2 ± 4.9 and had pitched an average of 119.6 ± 143.8 career games. Pitchers with partial articular-sided RTC tears (P = .04) or intra-articular BT hyperintensity (P = .04) on preseason MRI demonstrated an association with the need for future surgery. Pitchers with evidence of labral heterogeneity demonstrated greater total career pitch counts (10,034.1 vs 2,465.3; P = .04). Evidence of a posterior-superior humeral cyst was associated with decreased strikeouts per 9 innings (6.1 vs 8.0; P = .039) and total strikeout percentage (16.1% vs 23.2%; P = .04).

Conclusion: Although there was a significant difference in the percent of various radiographic findings between the injured and healthy cohort, no MRI findings were predictive of future IL placement or duration of placement. The presence of a posterior superior humeral cyst was associated with decreased strikeout rates at 2 and 3 years, the presence of a labral tear was associated with decreased earned run average (ERA) at 3 years and decreased career strikeout percentages, and increased capsular signal was associated with decreased 5-year ERA.

Level of evidence: Level IV, retrospective study.

PubMed Disclaimer

References

    1. Dillman C.J., Fleisig G.S., Andrews J.R. Biomechanics of pitching with emphasis upon shoulder kinematics. J Orthop Sports Phys Ther. 1993;18:402–408. - PubMed
    1. Fleisig G.S., Andrews J.R., Dillman C.J., Escamilla R.F. Kinetics of baseball pitching with implications about injury mechanisms. Am J Sports Med. 1995;23:233–239. - PubMed
    1. Weber A.E., Kontaxis A., O'Brien S.J., Bedi A. The biomechanics of throwing: Simplified and cogent. Sports Med Arthrosc Rev. 2014;22:72–79. - PubMed
    1. Wilk K.E., Meister K., Andrews J.R. Current concepts in the rehabilitation of the overhead throwing athlete. Am J Sports Med. 2002;30:136–151. - PubMed
    1. Gyftopoulos S., Recht M. The throwing shoulder: The common injuries and their underlying mechanisms. Semin Musculoskelet Radiol. 2014;18:404–411. - PubMed