Surf's up, but it can be a back breaker

CHICAGO - It doesn't matter if surfers are riding the Bonsai Pipeline off Oahu or catching the North Atlantic waves at Ballyshannon on the west coast of Ireland -- surfing can be a bone-breaking, tissue-searing experience that can land surfers in the hands of a radiologist, according to Dr. Jeremy Kuniyoshi, a radiology resident at the University of California, San Diego.

While there are many surfing injuries, "there is no database of these injuries available for radiologists," Dr. Kuniyoshi said. He and his colleagues are attempting to solve that problem by compiling a surfing injury database culled from medical records at level I and level II trauma centers around the world. Thus far, he and his colleagues have analyzed 135 radiologic images from patients with surfing injuries, he explained during a press conference at the RSNA meeting. He reported the data Tuesday in a poster presentation.

Kuniyoshi became intrigued by surfing injuries based on his own experience. "I had a number of injuries when I started surfing, and then I noticed that we were getting a number of surfing-related injuries in our ER," he said.

Surfers are generally injured in three ways: paddling toward the surf, "catching a wave," and by marine environment, a delicate reference to a not-so-delicate event -- shark attack.

Surfers paddling toward the waves are subject to various injuries including "surfer's knees," caused by kneeling while paddling, and facial fractures, caused when the board is pulled away by a wave, then smacked back on the surfer as the wave crests. Dr. Kuniyoshi illustrated this point with x-rays of a woman with a fractured jaw caused by this type of accident.

Another injury associated with paddling out are lacerations caused by the sharp fin on the bottom of the board. Dr. Kuniyoshi showed a film of a surfer who was impaled on the fin, causing a bowel laceration. Injuries from the fin have resulted in "safety modifications in which the fin is padded," he noted.

Injuries associated with "catching a wave" range from cervical fractures, caused when the surfer "hits bottom or runs into an object like a pier or a rock," to ankle sprains, caused when a surfer is dragged by the surfboard tether or "leash" that is usually worn on the ankle.

Dr. Kuniyoshi told in an interview that understanding surfing injuries is becoming more important because "the popularity of surfing both in the United States and worldwide is rapidly growing. As a result, the likelihood of seeing surfing injuries in radiology departments is increasing." By compiling a surfing injury database, Dr. Kuniyoshi and colleagues hope to provide a "valuable reference tool for radiologists who may not be familiar with surfing."

By Peggy Peck contributing writer
November 30, 2004

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