Acute Wiiitis

As a medical researcher, I have unlimited access to resources such as PubMed. I take my responsibility as wielder of this immense resource seriously. Charged as I am with the welfare of the public, I am excerpting in full a recent letter to the Editor from the New England Journal of Medicine:

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.2,3,4,5

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


  1. Brasington R. Nintendinitis. N Engl J Med 1990;322:1473-1474.
  2. Macgregor DM. Nintendonitis? A case report of repetitive strain injury in a child as a result of playing computer games. Scott Med J 2000;45:150-150.
  3. Koh TH. Ulcerative “nintendinitis”: a new kind of repetitive strain injury. Med J Aust 2000;173:671-671.
  4. Menz RJ. “Texting” tendinitis. Med J Aust 2005;182:308-308.
  5. Karim SA. Playstation thumb — a new epidemic in children. S Afr Med J 2005;95:412-412.

The full citation for this publication is: Bonis, J. Acute Wiiitis. NEJM, 356(23):2431-2 (2007). Full text PDF. PubMed ID: PMID 17554133