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Rock Climbing–Related Bone Marrow Edema of the Hand: A Follow-up Study

Lutter, Christoph, MD*,†,‡; Hochholzer, Thomas, MD; Bayer, Thomas, MD§; Schöffl, Volker, MD, PhD†,¶

Clinical Journal of Sport Medicine: July 2018 - Volume 28 - Issue 4 - p 382–388
doi: 10.1097/JSM.0000000000000463
Original Research

Objective: Sport climbers strain passive and active anatomical structures of their hands and fingers to the maximum during training or competition. This study was designed to investigate bone marrow edema (BME) in rock climbing athletes.

Design: Systematic detection, treatment, and follow-up investigation of rock climbing athletes with BME of the hand.

Setting: Primary-level orthopedic surgery and sports medicine division of a large academic medical center.

Patients: Thirty-one high-level climbers with diffuse pain in the hand and wrist joint caused by rock climbing were included in this study.

Interventions: The therapy consisted of consequent stress reduction and a break from sports.

Main Outcome Measures: Reduction of BME shown through magnetic resonance imaging (MRI) and regaining of preinjury climbing levels (Union Internationale des Associations d' Alpinisme metric scale).

Results: In 28 patients, MRI revealed osseous edema because of overload at the respective area of interest, mainly in the distal radius, the distal ulna, or the carpal bones, which could not be otherwise diagnosed as inflammations, tumors, or injuries. We classified these edemas and fractures of the hamate because of overload. The edema was a stress reaction to highly intensive training and climbing with presumably high traction to the wrist area. The control MRIs demonstrated that even with a consequent stress reduction, the edemas required 3 to 4 months to disappear completely.

Conclusions: Climbers with nonspecific, diffuse pain in the wrist and/or the fingers should be examined with MRI to detect or exclude the diagnosis of a BME.

*CVPath Institute, Gaithersburg, Maryland;

Departments of Sports Orthopedics and Traumatology, Klinikum Bamberg, Bamberg, Germany;

Private Clinic Hochrum, Innsbruck, Austria;

§Department of Radiology, Friedrich-Alexander University, Erlangen-Nuremberg, Erlangen, Germany; and

Department of Trauma and Orthopedic Surgery, Friedrich Alexander University, Erlangen-Nuremberg, Erlangen, Germany.

Corresponding Author: Christoph Lutter, MD, CVPath Institute, 19 Firstfield Rd, Gaithersburg, MD 20878 (

The authors report no conflicts of interest.

Received November 09, 2015

Accepted March 07, 2017

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.