Posterior circumflex humeral artery pathology and digital ischemia in elite volleyball: Symptoms, risk factors & suggestions for clinical management

J Sci Med Sport. 2018 Oct;21(10):1032-1037. doi: 10.1016/j.jsams.2018.03.010. Epub 2018 Mar 28.

Abstract

Objectives: To assess the association between posterior circumflex humeral artery (PCHA) pathology (PCHAP), symptoms and associated risk factors, in elite volleyball players, and to suggest profiles for clinical management and monitoring.

Design: Cross-sectional study.

Methods: A questionnaire assessed symptoms of digital ischemia (DI) in the dominant hand and risk factors among 278 elite indoor and beach volleyball players of whom 6.1% (17/278) was diagnosed with PCHAP using ultrasound. Odds Ratios (OR) including 95% confidence intervals (95%CI) were calculated using binary logistic regression.

Results: All 278 players completed the questionnaire. Three participants with PCHAP were symptomatic (18%). Ninety-three of 96 symptomatic participants had no PCHAP (OR=0.39; 95% CI 0.13-1.13). Total years playing volleyball (OR 1.14; 95% CI 1.03-1.25) and age (OR 1.17; 95% CI 1.00-1.29) were dose-response related risk factors: a volleyball career of ≥17 years and age of ≥27 years were associated with a 9-fold and 14-fold increased risk of PCHAP, respectively.

Conclusions: The volleyball career duration and age are dose-response related risk factors for PCHAP among elite indoor and beach volleyball players. DI symptoms are prevalent in a minority of athletes with PCHAP (3/17; 18%). To enable worldwide standardized care for these athletes at risk, four profiles for clinical management and monitoring have been suggested based on questionnaire and ultrasound outcomes.

Keywords: Aneurysm; Embolism; Monitoring; Overhead; Shoulder; Sports injuries.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Arteries / pathology*
  • Athletes
  • Cross-Sectional Studies
  • Female
  • Fingers / pathology*
  • Humans
  • Humerus / blood supply*
  • Ischemia / diagnosis*
  • Ischemia / pathology
  • Male
  • Prevalence
  • Risk Factors
  • Surveys and Questionnaires
  • Ultrasonography
  • Volleyball*
  • Young Adult