Purpose
To describe a spectrum of soft tissue,
bony and joint injuries presenting to
our institution,
caused by repeated micro trauma and overuse.
To analyse the imaging findings seen on conventional radiographs,
cross
sectional and SPECT/CT imaging.
To review the clinical & radiological outcomes on serial follow up of this cohort of patients.
Methods and Materials
Patients presenting to our institution with suspected overuse injuries and
atypical trauma were imaged and prospectively analysed.
There was no
change to the protocol of imaging,
management or clinical/radiological
follow up.
The scans were reported by a musculoskeletal radiologist and discussed
ur weeklymultidisciplinary meeting with a group of orthopedic
surgeons and physiotherapist,
trainees,
fellows and physician associates.
The outcomes were documented in the radiology reports,
operative notes,
clinic and follow up letters.
Soft tissue injuries include:
Tendonosis.
Tendon rupture
Brachialis syndrome
Nerve impingement,
including median...
Results
Through discussion of some of these cases,
wedemonstrate various scenarios presenting to our institution and the patient's outcomes.
Case 1: Achilles rupture in a football player
[Fig. 1 Fig. 2 Fig. 3]: Plain radiographs at the time of injury demonstrating soft tissue swelling and interruption of the normal Achilles outline.
[Fig. 4 Fig. 5 Fig. 6]: MRI imaging at the time of presentation confirming the clinical and radiographicfindings,
demonstrating the full extent of injury.
[Fig. 7 Fig. 8] : Post operative imaging 9 months later...
Conclusion
Overuse soft tissue and bony injuries are common in active individuals,
but particularly elite athletes.
MRI is the gold standard modality for imaging overuse injuries,
due to its sensitivity to early injury,
specificity to both soft tissue and bony injuries and relatively larger field of view.
This may assist in the diagnosis of other overuse injuries or alternative
pathology.
Its non-ionising properties render it ideal for imaging of young
individuals,
presenting with suspected overuse injuries for baseline
imaging and for follow up.
In our institution,...
References
Stanley LE,
Lucero A,
Mauntel TC,
Kennedy M,
Walker N,
Marshall SW,
Padua DA,
Berkoff DJ.
Achilles Tendon Adaptation in Cross-Country Runners Across a Competitive Season.Scand J Med Sci Sports.
2017 Apr 28.
doi: 10.1111/sms.12903.
[Epub ahead of print] PMID: 28455943
Lee KS,
Martin J,
Thelen D.
Science to Practice: Quantitative US Elastography Can Be Used to Quantify Mechanical and Histologic Tendon Healing in a Rabbit Model of Achilles Tendon Transection.
Radiology.
2017 May;283(2):311-313.
doi: 10.1148/radiol.2017170126.
PMID: 28418825
Korsh J,
Matijakovich D,
Gatt C.
Adolescent...
Personal Information
Dr Danoob Dalili
Specialist Registrar Clinical Radiology,
Imperial College London,
UK
Research fellow,
Guy's & St Thomas' NHS Foundation Trust,
London,
UK
Mr Mohit Bansal
Specialist Registrar Orthopaedic Surgeon,
Guy's & St Thomas' NHS Foundation Trust,
London,
UK
Nasha Khandwalla
Physician Associate,
Guy's & St Thomas' NHS Foundation Trust,
London,
UK
Mr Zameer Shah
Consultant Orthopaedic Hip Surgeon,
Guy's & St Thomas' NHS Foundation Trust,
London,
UK
Mr Marc George
Consultant Orthopaedic Hip Surgeon,
Guy's & St Thomas' NHS Foundation Trust,
London,
UK
Mr Marcus...