In a prospective study we examined the dominant shoulder of 11 athletes from the 1992 German Olympic water polo team. Their mean age was 25.4 +/- 3.5 years. Water polo had been practised generally for 14.1 +/- 4.3 years and professionally for 11.6 +/- 3.9 years. The weekly training amounted to between 12.5 and 19.5 hours. All athletes were submitted to standardised clinical, sonographical and MRI tests. In 5 cases we found anamnestic and/or clinical indications of rotator cuff pathology. In all 5 cases the supraspinatus tendon was affected, and in three cases both the supra- and the infraspinatus tendon were involved. Sonographically, no specific pathology except a thickened rotator cuff was seen. Remarkable changes were revealed by magnetic resonance imaging. In 8 cases changes were present in the insertion of the rotator cuff at the humeral head. The subacromial bursa was not pathologic. The tendon of the long head of the biceps was pathologically changed in 9 cases. In 7 athletes a so-called biceps halo and in two an osteophyte in the area of the bicipital groove was visible. In all of the 11 dominant shoulder joints massive hypertrophy of the articular capsule and pathologic changes of the anterior glenoid labrum existed. Occult osseous lesions were detected in 5 athletes, and osseous lesions of the humeral head in 8 athletes. In all athletes we could document degenerative changes at the acromioclavicular joints such as effusion in 7 cases, arthritis in two cases, and evident synovitis in two cases.
Clinical relevance: Many of the changes detected by MRI were not symptomatic.(ABSTRACT TRUNCATED AT 250 WORDS)