Hyperextension trauma to the elbow: radiological and ultrasonographic evaluation in handball goalkeepers.

OBJECTIVE To detect elbow lesions produced by hyperextension in 30 elite handball goalkeepers. METHODS Conventional radiographs, stress radiographs, and ultrasound examination of both elbows were used. As a control group, 30 male volunteers from the general population within the same age group with no history of elbow injury were used. RESULTS Radiographic findings in the goalkeepers were osteophyte formation in 67%, loose bodies in 5.5%, and periarticular calcification in 5.5%. Significantly greater differences in medial joint space opening between stressed and unstressed elbows were measured in both elbows than in the control group. Ultrasonographic findings showed thickening of the medial collateral ligament in 50%, thickening of the tricipital tendon in 11%, and signs of ulnar neuritis in 22%. An intra-articular effusion was found in 66% and small loose bodies in 33%. No significant differences were found between the dominant and non-dominant elbows at radiological and ultrasound examination. The findings in the control group were normal. CONCLUSIONS The findings support the theory that repetitive hyperextension trauma to the elbow in handball goalkeepers results in pathological changes.