Correspondence

Acute Wiiitis

N Engl J Med 2007; 356:2431-2432June 7, 2007

Article

To the Editor:

A healthy 29-year-old medical resident awoke one Sunday morning with intense pain in the right shoulder. He did not recall any recent injuries or trauma and had not participated in any sports or physical exercise recently. He consulted a rheumatology colleague. The Patte's test was positive, consistent with acute tendonitis isolated to the right infraspinatus.

After further review of his activities during the previous 24 hours, the patient recalled that he had bought a new Nintendo Wii (pronounced “wee”) video-game system and had spent several hours playing the tennis video game. With the Wii system, the player faces a video screen and moves a handheld controller (approximately 14.5 cm by 3.0 cm by 3.0 cm, with a weight of approximately 200 g) containing solid-state accelerometers and gyroscopes that sense three-dimensional spatial movements. In the tennis video game, the player makes the same arm movements as in a real game of tennis. If a player gets too engrossed, he may “play tennis” on the video screen for many hours. Unlike in the real sport, physical strength and endurance are not limiting factors.

The final diagnosis for the isolated right shoulder pain was Nintendinitis. However, the variant in this patient can be labeled more specifically as “Wiiitis.” The treatment consisted of ibuprofen for 1 week, as well as complete abstinence from playing Wii video games. The patient recovered fully. Nintendinitis was first described in 1990,1 and there have been many case reports of injuries related to intensive use of recreational technologies, mainly in children and mainly from intensive use of the extensor tendon of the thumb.2-5

With the growing use of this new video-game system, the risk of the Wiiitis variant may be higher than that of Nintendinitis reported in the literature, especially among adults. The available games for the Wii system already include golf, boxing, baseball, and bowling. Future games could involve different and unexpected groups of muscles. Physicians should be aware that there may be multiple, possibly puzzling presentations of Wiiitis.

Julio Bonis, M.D.
Instituto Municipal de Investigación Médica, E-08003 Barcelona, Spain
drbonis@gmail.com

5 References

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Citing Articles (12)

Citing Articles

1. 1

   N. Kluger, C. Pecquet. (2012) Dermatoses liées aux nouvelles technologies (téléphones portables, ordinateurs et jeux vidéo). Annales de Dermatologie et de Vénéréologie
   CrossRef

2. 2

   Hessom Razavi, Geoffrey Lam. (2011) Wii eye injury: Self-inflicted globe rupture and vision loss in a 7-year-old boy from a video game accident. Journal of American Association for Pediatric Ophthalmology and Strabismus 15:5, 491-492
   CrossRef

3. 3

   Michelle E. Kho, Abdulla Damluji, Jennifer M. Zanni, Dale M. Needham. (2011) Feasibility and observed safety of interactive video games for physical rehabilitation in the intensive care unit: a case series. Journal of Critical Care
   CrossRef

4. 4

   Allan L. Suttle, Erik A. Wallace. (2011) Disc Jockey Tenosynovitis. The American Journal of Medicine 124:4, e1
   CrossRef

5. 5

   Henri L Hurkmans, Gerard M Ribbers, Marjolein F Streur-Kranenburg, Henk J Stam, Rita J van den Berg-Emons. (2011) Energy expenditure in chronic stroke patients playing Wii Sports: a pilot study. Journal of NeuroEngineering and Rehabilitation 8:1, 38
   CrossRef

6. 6

   Anthony Joseph George. (2010) MUSCULO – SKE Wii TAL MEDICINE. Injury
   CrossRef

7. 7

   L. Straker, B. Maslen, R. Burgess-Limerick, P. Johnson, J. Dennerlein. (2010) Evidence-based guidelines for the wise use of computers by children: Physical development guidelines. Ergonomics 53:4, 458-477
   CrossRef

8. 8

   M. Huber, B. Rabin, C. Docan, G.C. Burdea, M. AbdelBaky, M.R. Golomb. (2010) Feasibility of Modified Remotely Monitored In-Home Gaming Technology for Improving Hand Function in Adolescents With Cerebral Palsy. IEEE Transactions on Information Technology in Biomedicine 14:2, 526-534
   CrossRef

9. 9

   Eley, Karen A., . (2010) A Wii Fracture. New England Journal of Medicine 362:5, 473-474
   Full Text

10. 10

    B. Kasraee, I. Masouyé, V. Piguet. (2009) PlayStation palmar hidradenitis. British Journal of Dermatology 160:4, 892-894
    CrossRef

11. 11

    Richard J. Robinson, Dominic A. Barron, Andrew J. Grainger, Ramakrishnan Venkatesh. (2008) Wii knee. Emergency Radiology 15:4, 255-257
    CrossRef

12. 12

    Michael P. Nett, Mark S. Collins, John W. Sperling. (2008) Magnetic resonance imaging of acute “wiiitis” of the upper extremity. Skeletal Radiology 37:5, 481-483
    CrossRef