Physeal Stress Injuries of the Wrist

The most common physeal stress injury in the wrist is radial epiphysitis, mostly seen in immature gymnasts that perform weight-bearing exercises on the extended wrist for a substantial number of hours per week. The injury is characterized by (dorsally located) wrist pain and the preferred primary choice of diagnostic imaging is conventional radiographs. A more detailed imaging of the growth plates in the wrist can be achieved using targeted magnetic resonance imaging sequences that allow both morphologic assessment as well as quantitative analysis of growth plate damage. Ulnar physeal stress injury is much less common than radial physeal stress injury, most likely due to the biomechanics of the immature wrist but has similar imaging characteristics. For both conditions, treatment includes immobilization to induce rest, as well as measures to prevent recurrence.