Little Leaguer Shoulder

  • Etiology: Stress injury to proximal humeral growth plate due to rotational stress during internal rotation and adduction with repeated overhead throwing
  • Imaging Radiograph:
    — On ipsilateral symptomatic side see proximal humeral epiphysiolysis and physeal widening and juxtaphyseal osteopenia and mild metaphyseal sclerosis in lateral aspect of proximal humeral physis
    — Comparison to contralateral asymptomatic side is helpful in making diagnosis
  • Imaging MRI:
    — Physeal widening and irregularity and widening and increased signal intensity within physis with disruption of expected trilaminar appearance
    — Bone marrow edema of proximal humeral metaphysis
  • DDX:
  • Complications: If not treated may develop premature physeal closure
  • Treatment: Resolves with rest
  • Clinical: Seen in adolescents in baseball and gymnastics and swimming and volleyball

Radiology Cases of Little Leaguer Shoulder

Radiograph of Littler Leaguer's shoulder
AP radiograph of the shoulder shows widening of the lateral aspect of the physis.
Radiograph of little leaguer shoulder
AP radiograph of the right shoulder (left) shows proximal humeral epiphysiolysis and physeal widening and juxtaphyseal osteopenia and mild metaphyseal sclerosis in the lateral aspect of the right proximal humeral physis. AP radiograph of the asymptomatic left shoulder (right) shows none of these findings.