Best Practice Case Studies-Vascular Problems in Elite Throwing Athletes

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Vascular injuries are a significant concern for elite throwing athletes, such as baseball players, who often experience conditions like thoracic outlet syndrome (TOS), axillary artery compression, and quadrilateral space syndrome. These issues, although uncommon, can mimic muscular injuries, leading to delayed diagnosis and potential severe consequences including thrombus formation, aneurysm rupture, and distal embolization.

The document highlights various vascular conditions affecting throwing athletes:

1. <strong>Arterial Thoracic Outlet Syndrome (aTOS):</strong> This condition involves subclavian artery compression, often due to anatomical abnormalities or muscle hypertrophy from repetitive throwing. Symptoms can include arm heaviness and decreased pitching endurance. Imaging such as ultrasound, CT, or MRA is essential for diagnosis. Surgical decompression is the primary treatment, potentially combined with arterial reconstruction if necessary.

2. <strong>Paget-Schroetter Syndrome (Venous TOS):</strong> This involves subclavian vein thrombosis due to compression during overhead arm use. Symptoms include arm swelling and cyanosis. Diagnosis may require CT or MR venography. Surgical decompression and circumferential venolysis are indicated, often preceded or followed by thrombolytic therapy.

3. <strong>Quadrilateral Space Syndrome (QSS):</strong> Rare, it involves PHCA compression, causing symptoms like arm pallor and ischemia. Surgical intervention may involve PHCA ligation.

4. <strong>Hypothenar Hammer Syndrome:</strong> Involves the ulnar artery and is common in athletes using bats or sticks. Non-surgical treatment focuses on equipment modification, while severe cases may require surgical intervention.

5. <strong>Repetitive Finger Trauma:</strong> Commonly affects pitchers and catchers, causing finger pain and ulceration due to mechanical and vascular stress. Treatment includes protective gear modification; surgery is for severe cases.

Timely identification and treatment of these vascular issues are crucial to prevent long-term damage and allow athletes to return to their sport.

Meta Tag

Edition 3rd Edition

Related Case 3rd Edition, CASE 57

Topic Vascular

Keywords

3rd Edition, CASE 57

3rd Edition

Vascular

vascular injuries

elite throwing athletes

thoracic outlet syndrome

axillary artery compression

quadrilateral space syndrome

arterial thoracic outlet syndrome

Paget-Schroetter syndrome

hypothenar hammer syndrome

repetitive finger trauma

diagnosis and treatment