Recognizing upper-extremity stress lesions.

Athletes in sports such as baseball, gymnastics, weight lifting, javelin, and racket sports are susceptible to stress lesions in the bones of the upper extremities. Injuries range from periostitis to bone spurs to stress fractures. Injuries in adolescents typically involve the growth plates, while midshaft injuries at the area of muscle insertion are more common in adults. It's especially important to detect these injuries in adolescents because untreated stress lesions at growth plates can have serious consequences. Plain films demonstrate obvious fractures and physeal injuries, but triple-phase bone scans are often needed to define the extent of stress lesions.