{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:26:23Z","timestamp":1777389983430,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2019,12,4]],"date-time":"2019-12-04T00:00:00Z","timestamp":1575417600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Prior studies have revealed magnetic resonance imaging (MRI) evidence of elbow pathology in single-season evaluation of competitive youth baseball players. The natural history of these findings and risk factors for progression have not been reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To characterize the natural history of bilateral elbow MRI findings in a 3-year longitudinal study and to correlate abnormalities with prior MRI findings, throwing history, playing status, and physical examination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study; Level of evidence, 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospective study of Little League players aged 12 to 15 years was performed. All players had preseason and postseason bilateral elbow MRI performed 3 years before this study. Players underwent repeat bilateral elbow MRI, physical examination, and detailed assessment of throwing history, playing status, and arm pain. Imaging was read by a blinded musculoskeletal radiologist and compared with prior MR images to assess for progression or resolution of previously identified pathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All 26 players who participated in the previous single-season study returned for a 3-year assessment. At the completion of the study, 15 players (58%) had dominant arm MRI pathology. Eighty percent (12\/15 players) of MRI findings were new or progressive lesions. Players with postseason MRI pathology at the beginning of the study were more likely to have MRI pathology at the 3-year follow-up than players with previously normal postseason MRI ( P &lt; .05), although 6 of the 14 players (43%) with previously normal MRI developed new pathology. Year-round play was a significant predictor of tenderness to elbow palpation ( P = .027) and positive MRI findings at 3 years ( P = .047). At the 3-year follow-up, 7 players (27%) reported having throwing elbow pain and 3 had required casting. Additionally, differences were noted in the dominant arm\u2019s internal and external rotation in those that continued to play baseball ( P &lt; .05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Dominant elbow MRI abnormalities are common in competitive Little League Baseball players. Year-round play imparts significant risk for progression of MRI pathology and physical examination abnormalities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0363546519888647","type":"journal-article","created":{"date-parts":[[2019,12,4]],"date-time":"2019-12-04T17:52:19Z","timestamp":1575481939000},"page":"466-472","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Progressive Elbow Magnetic Resonance Imaging Abnormalities in Little League Baseball Players Are Common: A 3-Year Longitudinal Evaluation"],"prefix":"10.1177","volume":"48","author":[{"given":"Joshua B.","family":"Holt","sequence":"first","affiliation":[{"name":"Pediatric Orthopedics & Scoliosis Center, Rady Children\u2019s Hospital, San Diego, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason M.","family":"Pedowitz","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of California, San Diego, San Diego, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip H.","family":"Stearns","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics & Scoliosis Center, Rady Children\u2019s Hospital, San Diego, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracey P.","family":"Bastrom","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics & Scoliosis Center, Rady Children\u2019s Hospital, San Diego, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Morgan","family":"Dennis","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics & Scoliosis Center, Rady Children\u2019s Hospital, San Diego, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerry R.","family":"Dwek","sequence":"additional","affiliation":[{"name":"Department of Radiology, Rady Children\u2019s Hospital, San Diego, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew T.","family":"Pennock","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics & Scoliosis Center, Rady Children\u2019s Hospital, San Diego, California, USA"},{"name":"Department of Orthopedic Surgery, University of California, San Diego, San Diego, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,12,4]]},"reference":[{"key":"bibr1-0363546519888647","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516629943"},{"key":"bibr2-0363546519888647","doi-asserted-by":"publisher","DOI":"10.1177\/2325967114553916"},{"key":"bibr3-0363546519888647","doi-asserted-by":"publisher","DOI":"10.1177\/1941738112454828"},{"key":"bibr4-0363546519888647","doi-asserted-by":"publisher","DOI":"10.1177\/2325967118818413"},{"key":"bibr5-0363546519888647","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510390185"},{"issue":"9","key":"bibr6-0363546519888647","first-page":"963","volume":"18","author":"Jobe FW","year":"1989","journal-title":"Orthop Rev"},{"key":"bibr7-0363546519888647","doi-asserted-by":"publisher","DOI":"10.1177\/0363546503262646"},{"key":"bibr8-0363546519888647","volume-title":"Protecting Young Pitching Arms. 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