Abstract
ObjectivesTo determine the prevalence of posterior circumflex humeral artery (PCHA) aneurysms and vessel characteristics of the PCHA and deep brachial artery (DBA) in elite volleyball players.MethodsTwo-hundred and eighty players underwent standardized ultrasound assessment of the dominant arm by a vascular technologist. Assessment included determination of PCHA aneurysms (defined as segmental vessel dilatation ≥150 %), PCHA and DBA anatomy, branching pattern, vessel course and diameter.ResultsThe PCHA and DBA were identified in 100 % and 93 % (260/280) of cases, respectively. The prevalence of PCHA aneurysms was 4.6 % (13/280). All aneurysms were detected in proximal PCHA originating from the axillary artery (AA). The PCHA originated from the AA in 81 % of cases (228/280), and showed a curved course dorsally towards the humeral head in 93 % (211/228). The DBA originated from the AA in 73 % of cases (190/260), and showed a straight course parallel to the AA in 93 % (177/190).ConclusionsPCHA aneurysm prevalence in elite volleyball players is high and associated with a specific branching type: a PCHA that originates from the axillary artery. Radiologists should have a high index of suspicion for this vascular overuse injury. For the first time vessel characteristics and reference values are described to facilitate ultrasound assessment.Key Points• Prevalence of PCHA aneurysms is 4.6 % among elite volleyball players.• All aneurysms are in proximal PCHA that originates directly from AA.• Vessel characteristics and reference values are described to facilitate US assessment.• Mean PCHA and DBA diameters can be used as reference values.• Radiologists need a high index of suspicion for this vascular overuse injury.
Highlights
Elite overhead athletes, like volleyball players, are at risk of ischaemic digits due to arterial emboli originating from an aneurysmal and thrombosed proximal posterior circumflex humeral artery (PCHA) in the dominant shoulder, the exact prevalence among these athletes is unknown [1]
All aneurysms were detected in proximal PCHA originating from the axillary artery (AA)
All aneurysms were detected in a PCHA that originated directly from the axillary artery
Summary
Like volleyball players, are at risk of ischaemic digits due to arterial emboli originating from an aneurysmal and thrombosed proximal posterior circumflex humeral artery (PCHA) in the dominant shoulder, the exact prevalence among these athletes is unknown [1]. The PCHA is a relatively small branch originating from the third part of the axillary artery (AA). It is frequently the last branch originating from the AA, with a prevalence of origin variations reported to be 33 − 42 % [2, 3], the deep brachial artery (DBA), which normally originates from the proximal brachial artery, may have an aberrant origin and arise from the dorsal AA, near to and closely resembling the PCHA The SPI-US protocol (Shoulder PCHA pathology and digital Ischemia – UltraSound protocol) can be used to assess PCHA and DBA anatomy, branching pattern, diameter measurement and detection of aneurysms [7, 8]. Reference values for arterial diameters should be considered when
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