While HIPAA regulations prevent anyone from disclosing anything about Aiken’s exam — and Houston has consistently declined to do so — it seems clear that the MRI of Aiken's elbow revealed an abnormality, reportedly a “small” ulnar collateral ligament, which is the ligament that must be repaired in Tommy John surgery. Dr. Josh Dines, who is a leading orthopedic surgeon at New York’s Hospital for Special Surgery but was not one of the five doctors with whom Aiken reportedly consulted and has never examined him nor his scans, told me that he has some trouble believing that to be the extent of the issue."
“No baseball player will have a normal MRI,” Dines said. “If someone has a congenitally small ulnar collateral ligament, even if they tear it and you reconstruct it, you can always make it bigger. And it’s almost a foregone conclusion these days that a young pitcher who throws in the upper 90s will at some point have a reconstruction anyway.
“When I read the reports about Aiken, I thought that there might be some concern about the bony anatomy where the ligament attaches, perhaps the medial epicondyle. If that is damaged or abnormal, you’re left with less bone there to reconstruct the ligament, and that can mean that a reconstruction won’t always work. They must have thought, for some reason, that a future reconstruction would not take.”
Aiken is currently healthy, and that is what his advisor, the prominent agent Casey Close, stressed in comments to
Ken Rosenthal of FoxSports.com. “Brady has been seen by some of the most experienced and respected orthopedic arm specialists in the country, and all of those doctors have acknowledged that he’s not injured and that he’s ready to start his professional career,” Close told Rosenthal last week.
Read between the lines, however, and you will notice that Close addressed only Aiken’s health at the moment, and not the concept that Aiken’s MRI revealed an abnormality that might unusually harm his career some years down the road — say, by 2017 or so. (Close did not respond to repeated interview requests by SI.com for this story.)