Are basketball players more likely to develop Hirayama disease?

Cabona, Corrado; Beronio, Alessandro; Martinelli, Ilaria; Briani, Chiara; Lapucci, Caterina; Serrati, Carlo; Delucchi, Stefano; Mannironi, Antonio; Benedetti, Luana

doi:10.1016/j.jns.2019.03.020

Cited by 9 publications

(3 citation statements)

References 14 publications

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“…13 Furthermore, HD is more common in tall individuals and in athletes who are subjected to increased neck flexion and trauma. 14 Our series does not support height as a possible risk factor since the mean height percentile was 55, though the majority of patients in this series (75.0%) regularly participated in organized athletics.…”

Section: Pathophysiologycontrasting

confidence: 64%

“…In addition, the disproportionate growth of the vertebral column relative to the spinal canal contents may be accelerated during periods of rapid growth, which could explain the typical onset of HD in late adolescence 13 . Furthermore, HD is more common in tall individuals and in athletes who are subjected to increased neck flexion and trauma 14 . Our series does not support height as a possible risk factor since the mean height percentile was 55, though the majority of patients in this series (75.0%) regularly participated in organized athletics.…”

Section: Discussionmentioning

confidence: 99%

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Single-institution Series of Hirayama Disease in North America

Lynch¹,

Slingerland²,

Robson³

et al. 2023

Clinical Spine Surgery: A Spine Publication

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Study Design: A retrospective chart review. Objective: The aims of this study were to review pathophysiology, workup, and treatment for Hirayama disease (HD); and to assess outcomes from a single institution. Summary of Background Data: HD is a rare, painless, cervical myelopathy with distal upper extremity weakness, muscle wasting, and spinal cord atrophy. Disease progression—a consequence of repeat flexion injury—occurs up to 5 years from the initial diagnosis. Methods: Single-institution review of pediatric HD patients from 2010 to 2020. Results: Patients (n=10 male, n=2 female) presented in the second decade (14–20 y) with painless progressive distal upper extremity weakness and atrophy without sensory loss. Electromyography (n=12) demonstrated denervation in C7–T1 myotomes and flexion/extension magnetic resonance imaging showed focal cord atrophy and anterior displacement of the posterior dura with epidural enhancement in flexion. Treatment included observation and external orthoses (n=9) and anterior cervical discectomy with fusion (n=3). One of the 9 patients managed conservatively experienced further deterioration; no patient who underwent anterior cervical discectomy with fusion progressed. Conclusions: Patients with HD require a multidisciplinary approach to diagnosis and treatment to preserve function. Treatment is preventive and aims to minimize flexion injury by inhibiting motion across involved joints. First-line management is avoidance of neck flexion and use of rigid orthosis; in cases of failed conservative management and/or rapid clinical deterioration, surgical fixation can be offered.

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Section: Pathophysiologycontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Single-institution Series of Hirayama Disease in North America

Lynch¹,

Slingerland²,

Robson³

et al. 2023

Clinical Spine Surgery: A Spine Publication

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“…1 It occurs predominantly in male adolescents as insidious onset, slowly progressive predominantly unilateral hand and forearm wasting and weakness (sparing the brachioradialis muscle), followed by a spontaneous arrest within several years. 2,3 Several cases or case series have been published, reviewing the demographics, epidemiology, clinical presentation, diagnoses, and treatment of Hirayama disease 1,[3][4][5][6][7] ; however, early recognition and diagnosis remain a clinical challenge among neurologists and non-neurologists.…”

Section: Discussionmentioning

confidence: 99%

Hirayama Disease: An Important Cause of Focal Hand Weakness in Young Adults

Jiang

Ubogu

2021

Journal of Investigative Medicine High Impact Case Reports

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Patients with progressive hand weakness may be seen in ambulatory medical clinics or in emergency rooms due to direct effects on activities of daily living or inadvertent injury associated with overuse or attempts to maintain normal function. It is important to recognize potential cause(s) and perform appropriate diagnostic tests and referrals that aid guide appropriate treatment that may lead to good outcomes. Hirayama disease is an underrecognized disorder in young adults due to an asymmetric growth-associated cervical spinal cord compression injury. Awareness of this disorder by internists, emergency room physicians, and radiologists would prevent unnecessary tests and interventions that may contribute to disease progression by delaying appropriate treatments or treating inappropriately, with consequential effects on outcomes. In this article, we describe 3 Hirayama disease cases from a single tertiary care institution and demonstrate how delayed diagnosis affected outcomes in 2 patients and early recognition facilitated improved outcomes in a patient.

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