Ulnar-sided wrist pain in elite tennis players: Magnetic resonance imaging abnormalities of the non-dominant wrist.

AIM: Ulnar-sided injuries of the non-dominant wrist are common in elite tennis players that use the double-handed backhand technique. This study aimed to define the relationship between ulnar-sided wrist pain in these patients and the presence of abnormalities on magnetic resonance imaging (MRI). METHOD(S): 14 symptomatic tennis players, 14 asymptomatic tennis players and 12 healthy controls who did not play tennis, were analysed prospectively, after undergoing MRI of their non-dominant wrist. Five anatomical regions were analysed, which were thought to relate to ulnar-sided wrist pain. These consisted of components of the triangular fibrocartilage complex (TFCC), ulnar collateral ligament (UCL), extensor carpi ulnaris tendon (ECU), osseous-articular structures and ganglia. Images were independently reviewed by two blinded musculoskeletal radiologists. RESULT(S): Non-dominant, ulnar-sided, wrist pain in symptomatic tennis players was significantly associated with an increased number of MRI abnormalities involving osseous structures (OR = 26.0, p = 0.02) and the dorsal radio-ulnar ligament (OR = 12.5, p = 0.03), compared with controls. A trend towards an association was seen in the number of MRI abnormalities of the ECU tendon in symptomatic players compared with asymptomatic players (OR = 8.0, p = 0.07). A relatively increased number of MRI abnormalities of the UCL was seen in symptomatic patients, but this did not reach statistical significance (p = 0.16). No statistically significant association was seen in the number of MRI abnormalities of any wrist structures between symptomatic and asymptomatic tennis players (p > 0.05), nor between asymptomatic tennis players and controls (p > 0.05). CONCLUSION(S): Non-dominant, ulnar-sided, wrist pain in elite tennis players is associated with an increased number of MRI abnormalities of osseous structures and the dorsal radio-ulnar ligament, compared with controls. However, as a similar number of MRI abnormalities are also s