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Effect of Long-Term Diving on the Morphology and Growth of the Distal Radial Epiphyseal Plate of Young Divers

A Magnetic Resonance Imaging Study

Zhang, Cici MD*; Shen, Si PhD; Zhang, Wen MD; Qiu, Lin PhD; Wu, Qingying BD; Wang, Fei PhD; Liu, Sirun MD

Clinical Journal of Sport Medicine: July 2019 - Volume 29 - Issue 4 - p 312–317
doi: 10.1097/JSM.0000000000000523
Original Research

Objective: To investigate the effects of long-term diving on the morphology and growth of the distal radial epiphyseal plate in young divers.

Study Design: Cohort study.

Setting: Guangzhou Sport University.

Participants: Thirty-eight professional divers, aged 10 to 17 years, and 25 age-matched volunteers.

Interventions: Each subject received a physical examination at the beginning of the study and underwent bilateral magnetic resonance imaging of the wrist. The divers were divided into 2 groups depending on the status of the epiphyseal plate: group A (positive distal radial epiphyseal plate injury) and group B (no positive distal radial epiphyseal plate injury). A third group, group C, consisted of the 25 volunteers.

Main Outcome Measures: The frequency of distal radial epiphyseal plate injury and the thickness of the distal radial epiphyseal plate were analyzed across the 3 groups.

Results: Twenty-nine cases (29/76, 38.15%) of distal radial epiphyseal plate injury were observed in 20 divers (20/38, 52.63%). The incidence of injury to the right hand was higher than that for the left (P = 0.009). There were statistically significant differences (P = 0.000) among the 3 groups in terms of epiphyseal plate thickness; group A > group B > group C.

Conclusions: Distal radial epiphyseal plate injury is common in divers, and more injuries are seen in the right hand. Moreover, growth of the radius was impaired in divers relative to controls. We consider that loading during diving may influence growth of the epiphyseal plate in either a transient or permanent manner.

*Department of Radiology, Guangzhou Red Cross Hospital, The Fourth Affiliated Hospital of Jinan University, Guangzhou, China;

Department of Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China; and

Department of Sport Medicine, GuangDong Sports Hospital, Guangzhou, China.

Corresponding Author: Sirun Liu, MD, No. 613, HangPu Road, TianHe District, Guangzhou, GuangDong, China 510000 (

The authors report no conflicts of interest.

C. Zhang and S. Shen contributed equally to this study.

Received November 22, 2016

Accepted June 22, 2017

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