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Physical activity increases synovial fluid in ankle tendon sheaths: an adjustment of MR Criteria is needed

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Abstract

Objectives

To compare the amount of fluid in synovial sheaths of the ankle before and after running. Our hypothesis was that this amount would increase and that the threshold for what is normally acceptable should be adjusted after physical activity.

Methods

Twenty-one healthy volunteers (n = 42 ankles) ran for 40 min on a treadmill. They underwent 3 T MRI before and immediately after running using a dedicated ankle coil. The images were stored and subsequently measured in a standardized way and independently read by two readers for fluid in the tendon sheaths in the retro and inframalleolar area. Statistics were performed for each tendon (Wilcoxon signed rank test), and also for the pooled data. Intraclass correlation coefficients were calculated.

Results

For reader 1, for all tendons the values after running increased without reaching statistical significance. For reader 2 this was not the case for all tendons but for most. When all the data were pooled (n = 800 measurements), the statistical difference before and after running was significant (p < 0.001).

Conclusion

Data pre and post-running show a trend of increasing synovial fluid, however, not significant for each individual tendon. The pooled data for all tendons, (n = 800) show a statistically significant increase after running (p < 0.001). The clinical implication is that the threshold for normally acceptable fluid should be adjusted if the patient undergoes an MR study after recent physical activity.

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Availability of data and materials

All the available measurement data are provided in the manuscript.

Abbreviations

PL:

Peroneus longus

PB:

Peroneus brevis

TP:

Tibialis posterior

FDL:

Flexor digitorum longus

FHL:

Flexor halluces longus

TA:

Tibialis anterior

EDL:

Extensor digitorum longus

EH:

Extensor hallucis

Pre:

Prior to running

Post:

Following the running exercise

References

  1. Akhbari P, Jaggard MK, Boulangé CL, Vaghela U, Graça G, Bhattacharya R, Lindon JC, Williams HRT, Gupte CM (2019) Differences in the composition of hip and knee synovial fluid in osteoarthritis: a nuclear magnetic resonance (NMR) spectroscopy study of metabolic profiles. Osteoarthr Cartil 27:1768–1777. https://doi.org/10.1016/j.joca.2019.07.017

    Article  CAS  Google Scholar 

  2. Burke CJ, Alizai H, Beltran LS, Regatte RR (2019) MRI of synovitis and joint fluid. J Magn Reson 49:1512–1527. https://doi.org/10.1002/jmri.26618

    Article  Google Scholar 

  3. Cheung Y, Rosenberg ZS, Magee T, Chinitz L (1992) Normal anatomy and pathologic conditions of ankle tendons: current imaging techniques. Radiographics 12:429–444. https://doi.org/10.1148/radiographics.12.3.1609136

    Article  CAS  Google Scholar 

  4. De Grove V, Willekens I, Lenchik L, Shahabpour M, de Mey J, De Maeseneer M (2018) Surg Radiol Anat 40:481–487. https://doi.org/10.1007/s00276-017-1924-x

    Article  Google Scholar 

  5. Hoessly ML, Wildi LM (2017) Magnetic Resonance Imaging Findings in the Knee Before and After Long-Distance Running-Documentation of Irreversible Structural Damage? A Systematic Review. Am J Sports Med 45:1206–1217. https://doi.org/10.1177/0363546516656180

    Article  Google Scholar 

  6. Kingston AR, Toms AP, Ghosh-Ray S, Johnston-Downing S (2009) Does running cause metatarsophalangeal joint effusions? A comparison of synovial fluid volumes on MRI in athletes before and after running. Skeletal Radiol 38:499–504. https://doi.org/10.1007/s00256-008-0641-2

    Article  Google Scholar 

  7. Nazarian LN, Rawool NM, Martin CE, Schweitzer ME (1995) Synovial fluid in the hindfoot and ankle: detection of amount and distribution with US. Radiology 197:275–278. https://doi.org/10.1148/radiology.197.1.7568837

    Article  CAS  Google Scholar 

  8. Otterness IG, Eskra JD, Bliven ML, Shay AK, Pelletier JP, Milici AJ (1998) Exercise protects against articular cartilage degeneration in the hamster. Arthritis Rheumatol 41:2068–2076. https://doi.org/10.1002/1529-0131(199811)41:11%3c2068::AID-ART23%3e3.0.CO;2-L

    Article  CAS  Google Scholar 

  9. Pratt DJ (1989) Mechanisms of shock attenuation via the lower extremity during running. Clin Biomech 4:51–57. https://doi.org/10.1016/0268-0033(89)90068-5

    Article  CAS  Google Scholar 

  10. Schmidt WA, Schmidt H, Schicke B, Gromnica-Ihle E (2004) Standard reference values for musculoskeletal ultrasonography. Ann Rheum 63:988–994. https://doi.org/10.1136/ard.2003.015081

    Article  CAS  Google Scholar 

  11. Schweitzer ME, van Leersum M, Ehrlich SS, Wapner K (1994) Fluid in normal and abnormal ankle joints: amount and distribution as seen on MR images. AJR Am J Roentgenol 162:111–114. https://doi.org/10.2214/ajr.162.1.8273647

    Article  CAS  Google Scholar 

  12. Teitz CC, Garrett WE Jr, Miniaci A, Lee MH, Mann RA (1997) Tendon problems inathletic individuals. Instr Course Lect 46:569–582. https://doi.org/10.2106/00004623-199701000-00016

    Article  CAS  Google Scholar 

  13. Trevino S, Baumhauer JF (1992) Tendon injuries of the foot and ankle. Clin Sports Med 11:727–739. https://doi.org/10.1016/S0278-5919(20)30481-6

    Article  CAS  Google Scholar 

  14. Wang YX, Westwood FR (2006) Fluid collection within the synovial sheath of the tendon of the flexor hallus longus muscle in the tarsal joint of rats: ananatomic variant detectable with magnetic resonance imaging. Lab Anim (NY) 40:58–62. https://doi.org/10.1258/002367706775404381

    Article  CAS  Google Scholar 

  15. Willekens I, Shahabpour M, Lenchik L, Buls N, De Mey J, Provyn S, De Maeseneer M (2019) Fluid distribution in ankle tendon sheaths in healthy volunteers: MRI findings. Surg Radiol Anat 41:1445–1449. https://doi.org/10.1007/s00276-019-02355-z

    Article  Google Scholar 

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Funding

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Authors and Affiliations

  1. Department of Radiology, UZ Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium

    Michel De Maeseneer, Seema Doering, Nico Buls, Johan de Mey, Maryam Shahabpour & Inneke Willekens

  2. Department of Radiology, Brugmann University Hospital, Brussels, Belgium

    Veerle De Grove

  3. Department of Experimental Anatomy, VUB, Brussels, Belgium

    Steven Provyn

Authors
  1. Michel De Maeseneer
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  2. Seema Doering
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  3. Veerle De Grove
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  4. Nico Buls
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  5. Johan de Mey
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  6. Maryam Shahabpour
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  7. Steven Provyn
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  8. Inneke Willekens
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Contributions

MD: study design, manuscript writing, SD: data collection, VDG: data collection, NB: statistical analysis, JDM: study design, manuscript review, MS: manuscript writing and review, SP: study design, data collection, IW: study design, experiment, data analysis.

Corresponding author

Correspondence to Michel De Maeseneer.

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The authors declare no competing interests.

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No conflicts of interest or competing interests to declare by the authors.

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Ethical committees Vrije Universiteit Brussel. Consent to participate and consent to publish were obtained from the subjects.

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De Maeseneer, M., Doering, S., De Grove, V. et al. Physical activity increases synovial fluid in ankle tendon sheaths: an adjustment of MR Criteria is needed. Surg Radiol Anat 45, 193–199 (2023). https://doi.org/10.1007/s00276-022-03068-6

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  • DOI: https://doi.org/10.1007/s00276-022-03068-6

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