无症状业余老年网球运动员肘关节伸肌总腱超声改变患病率及其与优势臂和反手技术的关系
纳入102名参加法国全国网球锦标赛的无症状老年网球运动员，行临床评估和肘部超声检查。58.8%的运动员超声检出至少一项伸肌总腱形态异常，多见于优势肘（47/60）；腱撕裂21例，多位于优势侧（17/21）。伸肌总腱改变与优势肘显著相关，与反手技术无关，异常血管化少见，PRTEE评分在形态正常与异常者间无显著差异。
要点
- 无症状老年网球运动员伸肌总腱形态异常常见，患病率约58.8%。
- 伸肌总腱改变（含腱撕裂）与优势肘显著相关，与反手技术无关。
- 该人群伸肌总腱异常血管化少见，PRTEE评分与腱形态无显著关联。
关键影像表现/征象
- 102名无症状运动员中60名（58.8%）超声检出至少一项伸肌总腱形态异常。
- 伸肌总腱形态异常最常见于优势肘（47/60）。
- 21名运动员检出腱撕裂，主要累及优势侧（17/21）。
- 该人群中伸肌总腱异常血管化少见。
临床应用与阅片要点
- 阅片时注意伸肌总腱形态改变（含撕裂）在无症状老年网球运动员优势肘中常见，报告需结合临床避免过度诊断。
- 伸肌总腱异常血管化在该人群少见，多普勒评估可作为辅助而非主要依据。
- 反手技术（单手与双手）与伸肌总腱形态改变无显著关联，不应据此推断技术类型。
局限性
- 研究为单中心设计，样本来自法国全国锦标赛老年网球运动员，结果外推需谨慎。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
OBJECTIVE: To assess the prevalence of ultrasound-detected changes in the common extensor tendon (CET) and their association with arm dominance and backhand technique in asymptomatic tennis players.
MATERIALS AND METHODS: Senior tennis players competing in the French National Tennis Championship who consented to clinical and ultrasound examination of their elbows were included. Clinical evaluation consisted of the Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire, palpation of the lateral epicondyle, and the Cozen and Maudsley tests. Ultrasound assessment of the CET focused on detecting morphological changes (including tears) and evaluating tendon vascularization using Doppler imaging. Logistic regression was employed to analyze the relationships between ultrasound-detected CET changes and arm dominance (dominant vs. non-dominant elbow) as well as backhand technique (one-handed vs. two-handed). Associations between CET morphology and PRTEE scores were also examined.
RESULTS: Among 102 asymptomatic players, 60 (58.8%) had at least one ultrasound-detected morphological abnormality of the CET, most frequently in the dominant elbow (47/60). Tendon tears were identified in 21 players, predominantly affecting the dominant side (17/21). We found a strong association of changes in CET with the dominant elbow, including tendon tears. No significant relationship was found between CET morphological changes and backhand technique. Abnormal vascularization of the CET was infrequent in this population. Additionally, no significant differences in mean PRTEE scores were observed between players with normal and abnormal CET morphology.
CONCLUSION: Morphological changes in the CET were frequent in asymptomatic senior tennis players. These changes were strongly associated with the dominant arm but not with backhand technique.
引用
- Crema MD, Guillard V, Levavasseur G, et al. Prevalence of ultrasound-detected changes in the common extensor tendon of the elbow in asymptomatic amateur senior tennis players: associations with dominant arm and backhand technique. Skeletal Radiol. 2026. PMID: 42171635. doi:10.1007/s00256-026-05253-9
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。