TY - JOUR T1 - Dissociation between back pain and bone stress reaction as measured by CT scan in young cricket fast bowlers JF - British Journal of Sports Medicine JO - Br J Sports Med SP - 586 LP - 591 DO - 10.1136/bjsm.2003.006585 VL - 38 IS - 5 AU - H B Millson AU - J Gray AU - R A Stretch AU - M I Lambert Y1 - 2004/10/01 UR - http://bjsm.bmj.com/content/38/5/586.abstract N2 - Background: Bone stress reaction is prevalent among cricket fast bowlers. Few studies have addressed the sensitivity and specificity of imaging for diagnosis, and follow up assessment has been poorly investigated. Objective: To determine whether there was an association between back pain and bone stress reaction as measured by computed tomography (CT) scan in young cricket fast bowlers. Methods: Ten young cricket fast bowlers were included in the study. Nine bowlers presented to a physiotherapy practice with low back pain and were later diagnosed with lumbar stress fractures, while one was an experienced bowler with no pain. All players had a CT scan after presenting to the physiotherapy practice. Pain was assessed according to a subjective scale (0–10) where 10 represented the player’s subjective, maximum pain score. Recovery and rehabilitation of all players was monitored until they returned to full participation. Results: There was no consistency in the relationship between pain and CT scan results. For example, one subject had evidence of un-united stress fractures after 15 months of rest but had experienced moderate pain for only 2 weeks after the onset of symptoms, in contrast to another subject who had intermittent pain for 11 months even though CT scan showed multiple stress fractures ranging from partially healed to fully healed status at 3 months. Conclusion: There is dissociation between back pain and bone stress reaction as measured by CT scan. Therefore, CT scan does not provide objective evidence for ongoing management or decision concerning return to sport in cricket fast bowlers. ER -