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The Role of Radiologic Imaging Techniques in Pathophysiology of Sports Injuries (Including Follow-Up)

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Nuclear Medicine and Radiologic Imaging in Sports Injuries

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Abstract

The incidence of sports-related injuries is increasing. While radiologic techniques have improved and the need for early diagnosis is rising, imaging plays a more prominent role in the management of these sports-related injuries. The choice of the imaging modality depends on costs, availability, radiation dose and accuracy for specific tissues or injuries. Comprehension of the underlying pathophysiologic and biomechanical mechanisms of the injury in a multidisciplinary setting is essential for choice of modality and image interpretation.

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References

  • Abate M, Salini V, Rimondi E, Errani C, Alberghini M, Mercuri M, Pelotti P (2011) Post traumatic myositis ossificans: sonographic findings. J Clin Ultrasound 39(3):135–140

    Article  PubMed  Google Scholar 

  • Ahmad CS, Redler LH, Ciccotti MG, Maffulli N, Longo UG, Bradley J (2013) Evaluation and management of hamstring injuries. Am J Sports Med 41(12):2933–2947

    Article  PubMed  Google Scholar 

  • Ahmed R, Nazarian LN (2010) Overview of musculoskeletal sonography. Ultrasound Q 26(1):27–35

    Article  PubMed  Google Scholar 

  • Allen GM (2007) Tendon and ligamentous trauma. In: Vanhoenacker FM et al (eds) Imaging of orthopedic sports injuries, 1st edn. Springer, Berlin/Heidelberg

    Google Scholar 

  • Allen GM, Wilson DJ (2007) Ultrasound in sports medicine–a critical evaluation. Eur J Radiol 62(1):79–85

    Article  PubMed  Google Scholar 

  • Askling CM, Tengvar M, Saartok T, Thorstensson A (2007) Acute first-time hamstring strains during high-speed running: a longitudinal study including clinical and magnetic resonance imaging findings. Am J Sports Med 35(2):197–206

    Article  PubMed  Google Scholar 

  • Askling CM, Tengvar M, Thorstensson A (2013) Acute hamstring injuries in Swedish elite football: a prospective randomised controlled clinical trial comparing two rehabilitation protocols. Br J Sports Med 47(15):953–959

    Article  PubMed  Google Scholar 

  • Bergman AG, Fredericson M, Ho C, Matheson GO (2004) Asymptomatic tibial stress reactions: MRI detection and clinical follow-up in distance runners. AJR Am J Roentgenol 183(3):635–638

    Article  PubMed  Google Scholar 

  • Black BR, Chong le R, Potter HG (2009) Cartilage imaging in sports medicine. Sports Med Arthrosc 17(1):68–80

    Article  PubMed  Google Scholar 

  • Blankenbaker DG, De Smet AA (2010) Hip injuries in athletes. Radiol Clin North Am 48(6):1155–1178

    Article  PubMed  Google Scholar 

  • Bucklein W, Vollert K, Wohlgemuth WA, Bohndorf K (2000) Ultrasonography of acute musculoskeletal disease. Eur Radiol 10(2):290–296

    Article  CAS  PubMed  Google Scholar 

  • Burne SG, Mahoney CM, Forster BB, Koehle MS, Taunton JE, Khan KM (2005) Tarsal navicular stress injury: long-term outcome and clinicoradiological correlation using both computed tomography and magnetic resonance imaging. Am J Sports Med 33(12):1875–1881

    Article  PubMed  Google Scholar 

  • Chang A, Miller TT (2009) Imaging of tendons. Sports Health 1(4):293–300

    Article  PubMed Central  PubMed  Google Scholar 

  • Connell DA, Schneider-Kolsky ME, Hoving JL, Malara F, Buchbinder R, Koulouris G, Burke F, Bass C (2004) Longitudinal study comparing sonographic and MRI assessments of acute and healing hamstring injuries. AJR Am J Roentgenol 183(4):975–984

    Article  PubMed  Google Scholar 

  • Cook JL, Purdam CR (2009) Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J Sports Med 43(6):409–416

    Article  CAS  PubMed  Google Scholar 

  • Crema MD, Roemer FW, Marra MD, Burstein D, Gold GE, Eckstein F, Baum T, Mosher TJ, Carrino JA, Guermazi A (2011) Articular cartilage in the knee: current MR imaging techniques and applications in clinical practice and research. Radiographics 31(1):37–61

    Article  PubMed  Google Scholar 

  • De Filippo M, Bertellini A, Pogliacomi F, Sverzellati N, Corradi D, Garlaschi G, Zompatori M (2009) Multidetector computed tomography arthrography of the knee: diagnostic accuracy and indications. Eur J Radiol 70(2):342–351

    Article  PubMed  Google Scholar 

  • de Windt TS, Welsch GH, Brittberg M, Vonk LA, Marlovits S, Trattnig S, Saris DB (2013) Is magnetic resonance imaging reliable in predicting clinical outcome after articular cartilage repair of the knee? A systematic review and meta-analysis. Am J Sports Med 41(7):1695–1702

    Article  PubMed  Google Scholar 

  • Demeijere A, Vanhoenacker FM (2007) Overuse bone trauma and stress fractures. In: Vanhoenacker FM et al (eds) Imaging of orthopedic sports injuries, 1st edn. Springer, Berlin/Heidelberg

    Google Scholar 

  • Dobrindt O, Hoffmeyer B, Ruf J, Seidensticker M, Steffen IG, Fischbach F, Zarva A, Wieners G, Ulrich G, Lohmann CH, Amthauer H (2012) Estimation of return-to-sports-time for athletes with stress fracture – an approach combining risk level of fracture site with severity based on imaging. BMC Musculoskelet Disord 13:139

    Article  PubMed Central  PubMed  Google Scholar 

  • Duc SR, Pfirrmann CW, Schmid MR, Zanetti M, Koch PP, Kalberer F, Hodler J (2007) Articular cartilage defects detected with 3D water-excitation true FISP: prospective comparison with sequences commonly used for knee imaging. Radiology 245(1):216–223

    Article  PubMed  Google Scholar 

  • Ekstrand J, Healy JC, Walden M, Lee JC, English B, Hagglund M (2012) Hamstring muscle injuries in professional football: the correlation of MRI findings with return to play. Br J Sports Med 46(2):112–117

    Article  PubMed  Google Scholar 

  • Erickson SJ, Cox IH, Hyde JS, Carrera GF, Strandt JA, Estkowski LD (1991) Effect of tendon orientation on MR imaging signal intensity: a manifestation of the “magic angle” phenomenon. Radiology 181(2):389–392

    Article  CAS  PubMed  Google Scholar 

  • Fornage BD, Eftekhari F (1989) Sonographic diagnosis of myositis ossificans. J Ultrasound Med 8(8):463–466

    CAS  PubMed  Google Scholar 

  • Fredericson M, Jennings F, Beaulieu C, Matheson GO (2006) Stress fractures in athletes. Top Magn Reson Imaging 17(5):309–325

    Article  PubMed  Google Scholar 

  • Froeling M, Oudeman J, van den Berg S, Nicolay K, Maas M, Strijkers GJ, Drost MR, Nederveen AJ (2010) Reproducibility of diffusion tensor imaging in human forearm muscles at 3.0 T in a clinical setting. Magn Reson Med 64(4):1182–1190

    Article  PubMed  Google Scholar 

  • Gaeta M, Minutoli F, Scribano E, Ascenti G, Vinci S, Bruschetta D, Magaudda L, Blandino A (2005) CT and MR imaging findings in athletes with early tibial stress injuries: comparison with bone scintigraphy findings and emphasis on cortical abnormalities. Radiology 235(2):553–561

    Article  PubMed  Google Scholar 

  • Garcia T, Hornof WJ, Insana MF (2003) On the ultrasonic properties of tendon. Ultrasound Med Biol 29(12):1787–1797

    Article  PubMed  Google Scholar 

  • Gibbs NJ, Cross TM, Cameron M, Houang MT (2004) The accuracy of MRI in predicting recovery and recurrence of acute grade one hamstring muscle strains within the same season in Australian Rules football players. J Sci Med Sport 7(2):248–258

    Article  CAS  PubMed  Google Scholar 

  • Greco A, McNamara MT, Escher RM, Trifilio G, Parienti J (1991) Spin-echo and STIR MR imaging of sports-related muscle injuries at 1.5 T. J Comput Assist Tomogr 15(6):994–999

    Article  CAS  PubMed  Google Scholar 

  • Hodgson RJ, O’Connor PJ, Grainger AJ (2012) Tendon and ligament imaging. Br J Radiol 85(1016):1157–1172

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Huysse WC, Verstraete KL (2007) Cartilage trauma. In: Vanhoenacker FM et al (eds) Imaging of orthopedic sports injuries, 1st edn. Springer, Berlin/Heidelberg

    Google Scholar 

  • Junge A, Dvorak J (2013) Injury surveillance in the World Football Tournaments 1998–2012. Br J Sports Med 47(12):782–788

    Article  PubMed Central  PubMed  Google Scholar 

  • Kaeding CC, Miller T (2013) The comprehensive description of stress fractures: a new classification system. J Bone Joint Surg Am 95(13):1214–1220

    Article  PubMed  Google Scholar 

  • Kainberger F, Weidekamm C (2005) Tendon and muscle imaging in sports. Imaging Decisions MRI 9(3):6–12

    Article  Google Scholar 

  • Kerkhoffs GM, van Es N, Wieldraaijer T, Sierevelt IN, Ekstrand J, van Dijk CN (2013) Diagnosis and prognosis of acute hamstring injuries in athletes. Knee Surg Sports Traumatol Arthrosc 21(2):500–509

    Article  PubMed Central  PubMed  Google Scholar 

  • Kijowski R, Blankenbaker DG, Klaers JL, Shinki K, De Smet AA, Block WF (2009a) Vastly undersampled isotropic projection steady-state free precession imaging of the knee: diagnostic performance compared with conventional MR. Radiology 251(1):185–194

    Article  PubMed  Google Scholar 

  • Kijowski R, Davis KW, Woods MA, Lindstrom MJ, De Smet AA, Gold GE, Busse RF (2009b) Knee joint: comprehensive assessment with 3D isotropic resolution fast spin-echo MR imaging–diagnostic performance compared with that of conventional MR imaging at 3.0 T. Radiology 252(2):486–495

    Article  PubMed  Google Scholar 

  • Kramer DE, Pace JL, Jarrett DY, Zurakowski D, Kocher MS, Micheli LJ (2013) Diagnosis and management of symptomatic muscle herniation of the extremities: a retrospective review. Am J Sports Med 41(9):2174–2180

    Article  PubMed  Google Scholar 

  • Lee JC, Mitchell AW, Healy JC (2012) Imaging of muscle injury in the elite athlete. Br J Radiol 85(1016):1173–1185

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Lee RK, Ng AW, Tong CS, Griffith JF, Tse WL, Wong C, Ho PC (2013) Intrinsic ligament and triangular fibrocartilage complex tears of the wrist: comparison of MDCT arthrography, conventional 3-T MRI, and MR arthrography. Skeletal Radiol 42(9):1277–1285

    Article  CAS  PubMed  Google Scholar 

  • Maffulli N, Khan KM, Puddu G (1998) Overuse tendon conditions: time to change a confusing terminology. Arthroscopy 14(8):840–843

    Article  CAS  PubMed  Google Scholar 

  • Magee T (2009) 3-T MRI of the shoulder: is MR arthrography necessary? AJR Am J Roentgenol 192(1):86–92

    Article  PubMed  Google Scholar 

  • Marlovits S, Striessnig G, Resinger CT, Aldrian SM, Vecsei V, Imhof H, Trattnig S (2004) Definition of pertinent parameters for the evaluation of articular cartilage repair tissue with high-resolution magnetic resonance imaging. Eur J Radiol 52(3):310–319

    Article  PubMed  Google Scholar 

  • Marlovits S, Singer P, Zeller P, Mandl I, Haller J, Trattnig S (2006) Magnetic resonance observation of cartilage repair tissue (MOCART) for the evaluation of autologous chondrocyte transplantation: determination of interobserver variability and correlation to clinical outcome after 2 years. Eur J Radiol 57(1):16–23

    Article  PubMed  Google Scholar 

  • Matheson GO, Clement DB, McKenzie DC, Taunton JE, Lloyd-Smith DR, MacIntyre JG (1987) Stress fractures in athletes. A study of 320 cases. Am J Sports Med 15(1):46–58

    Article  CAS  PubMed  Google Scholar 

  • McGuire CM, MacMahon P, Byrne DP, Kavanagh E, Mulhall KJ (2012) Diagnostic accuracy of magnetic resonance imaging and magnetic resonance arthrography of the hip is dependent on specialist training of the radiologist. Skeletal Radiol 41(6):659–665

    Article  PubMed  Google Scholar 

  • Mueller-Wohlfahrt HW, Haensel L, Mithoefer K, Ekstrand J, English B, McNally S, Orchard J, van Dijk CN, Kerkhoffs GM, Schamasch P, Blottner D, Swaerd L, Goedhart E, Ueblacker P (2013) Terminology and classification of muscle injuries in sport: the Munich consensus statement. Br J Sports Med 47(6):342–350

    Article  PubMed Central  PubMed  Google Scholar 

  • Mulligan ME (1995) The “gray cortex”: an early sign of stress fracture. Skeletal Radiol 24(3):201–203

    Article  CAS  PubMed  Google Scholar 

  • Nattiv A, Kennedy G, Barrack MT, Abdelkerim A, Goolsby MA, Arends JC, Seeger LL (2013) Correlation of MRI grading of bone stress injuries with clinical risk factors and return to play: a 5-year prospective study in collegiate track and field athletes. Am J Sports Med 41(8):1930–1941

    Article  PubMed Central  PubMed  Google Scholar 

  • Neustadter J, Raikin SM, Nazarian LN (2004) Dynamic sonographic evaluation of peroneal tendon subluxation. AJR Am J Roentgenol 183(4):985–988

    Article  PubMed  Google Scholar 

  • Notohamiprodjo M, Horng A, Kuschel B, Paul D, Li G, Raya JG, Reiser MF, Glaser C (2012) 3D-imaging of the knee with an optimized 3D-FSE-sequence and a 15-channel knee-coil. Eur J Radiol 81(11):3441–3449

    Article  PubMed  Google Scholar 

  • Papalada A, Malliaropoulos N, Tsitas K, Kiritsi O, Padhiar N, Del BA, Maffulli N (2012) Ultrasound as a primary evaluation tool of bone stress injuries in elite track and field athletes. Am J Sports Med 40(4):915–919

    Article  PubMed  Google Scholar 

  • Peetrons P (2002) Ultrasound of muscles. Eur Radiol 12(1):35–43

    Article  CAS  PubMed  Google Scholar 

  • Roemer FW, Hunter DJ, Guermazi A (2009) MRI-based semiquantitative assessment of subchondral bone marrow lesions in osteoarthritis research. Osteoarthritis Cartilage 17(3):414–415

    Article  CAS  PubMed  Google Scholar 

  • Roemer FW, Crema MD, Trattnig S, Guermazi A (2011) Advances in imaging of osteoarthritis and cartilage. Radiology 260(2):332–354

    Article  PubMed  Google Scholar 

  • Royer M, Thomas T, Cesini J, Legrand E (2012) Stress fractures in 2011: practical approach. Joint Bone Spine 79(Suppl 2):S86–S90

    Article  PubMed  Google Scholar 

  • Silder A, Heiderscheit BC, Thelen DG, Enright T, Tuite MJ (2008) MR observations of long-term musculotendon remodeling following a hamstring strain injury. Skeletal Radiol 37(12):1101–1109

    Article  PubMed Central  PubMed  Google Scholar 

  • Silder A, Sherry MA, Sanfilippo J, Tuite MJ, Hetzel SJ, Heiderscheit BC (2013) Clinical and morphological changes following 2 rehabilitation programs for acute hamstring strain injuries: a randomized clinical trial. J Orthop Sports Phys Ther 43(5):284–299

    Article  PubMed Central  PubMed  Google Scholar 

  • Slavotinek JP, Verrall GM, Fon GT (2002) Hamstring injury in athletes: using MR imaging measurements to compare extent of muscle injury with amount of time lost from competition. AJR Am J Roentgenol 179(6):1621–1628

    Article  PubMed  Google Scholar 

  • Theodoropoulos JS, Andreisek G, Harvey EJ, Wolin P (2010) Magnetic resonance imaging and magnetic resonance arthrography of the shoulder: dependence on the level of training of the performing radiologist for diagnostic accuracy. Skeletal Radiol 39(7):661–667

    Article  PubMed  Google Scholar 

  • Tok F, Ozcakar L, De MM, Kara M, Vanderstraeten G (2012) Musculoskeletal ultrasound for sports injuries. Eur J Phys Rehabil Med 48(4):651–663

    CAS  PubMed  Google Scholar 

  • Verhagen RA, Maas M, Dijkgraaf MG, Tol JL, Krips R, van Dijk CN (2005) Prospective study on diagnostic strategies in osteochondral lesions of the talus. Is MRI superior to helical CT? J Bone Joint Surg Br 87(1):41–46

    CAS  PubMed  Google Scholar 

  • Verrall GM, Slavotinek JP, Barnes PG, Fon GT (2003) Diagnostic and prognostic value of clinical findings in 83 athletes with posterior thigh injury: comparison of clinical findings with magnetic resonance imaging documentation of hamstring muscle strain. Am J Sports Med 31(6):969–973

    PubMed  Google Scholar 

  • Waldt S, Bruegel M, Ganter K, Kuhn V, Link TM, Rummeny EJ, Woertler K (2005) Comparison of multislice CT arthrography and MR arthrography for the detection of articular cartilage lesions of the elbow. Eur Radiol 15(4):784–791

    Article  CAS  PubMed  Google Scholar 

  • Yoshioka H, Stevens K, Hargreaves BA, Steines D, Genovese M, Dillingham MF, Winalski CS, Lang P (2004) Magnetic resonance imaging of articular cartilage of the knee: comparison between fat-suppressed three-dimensional SPGR imaging, fat-suppressed FSE imaging, and fat-suppressed three-dimensional DEFT imaging, and correlation with arthroscopy. J Magn Reson Imaging 20(5):857–864

    Article  PubMed  Google Scholar 

  • Zaraiskaya T, Kumbhare D, Noseworthy MD (2006) Diffusion tensor imaging in evaluation of human skeletal muscle injury. J Magn Reson Imaging 24(2):402–408

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands

    Charlotte M. Nusman

  2. Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Mario Maas MD, PhD

  3. Department of Orthopaedic Surgery, Academic Medical Centre, Amsterdam, The Netherlands

    Gino M. Kerkhoffs

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  1. Charlotte M. Nusman
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  2. Gino M. Kerkhoffs
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  3. Mario Maas MD, PhD
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Correspondence to Mario Maas MD, PhD .

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Editors and Affiliations

  1. Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Andor W.J.M. Glaudemans

  2. Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Rudi A.J.O. Dierckx

  3. Department of Radiology, Antwerp University Hospital, Edegem, Belgium

    Jan L.M.A. Gielen

  4. Exercise and Health, Center for Sports Medicine, University Center for Sport, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Johannes (Hans) Zwerver

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Nusman, C.M., Kerkhoffs, G.M., Maas, M. (2015). The Role of Radiologic Imaging Techniques in Pathophysiology of Sports Injuries (Including Follow-Up). In: Glaudemans, A., Dierckx, R., Gielen, J., Zwerver, J. (eds) Nuclear Medicine and Radiologic Imaging in Sports Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46491-5_5

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