Foot and Ankle Imaging in the Athlete
Section snippets
Sesamoiditis
Pain in the first metatarsophalangeal joint sesamoids is a commonly occurring clinical entity and represents up to 4% of overuse foot injuries [8]. The sesamoid complex normally transmits up to 50% of body weight and, during push-off, can transmit loads greater than 300%. These high stresses may lead to acute and chronic pathologies of the sesamoids [9]. Injuries involving the sesamoids may occur in a number of sports including running, basketball, gymnastics, high-impact aerobics, and dancing.
Turf toe
Turf toe is a traumatic injury of the first metatarsophalangeal joint that results in a ligamentous or capsular sprain of the joint. This injury most commonly occurs as a hyperextension of the joint, with hyperflexion and valgus strain as other mechanisms of injury. This injury is seen in sports such as football, soccer, and dance that have artificial playing surfaces, and the accompanying use of lighter footwear is thought to play a role in its occurrence [18]. The injury carries with it
Stress fractures
A stress fracture is a partial or complete bone fracture that results from repeated application of stress lower than that required to fracture the bone in a single loading [22]. The process begins with an increased rate of osseous remodeling, followed by resorption and rarefaction. Eventually, focal trabecular microfractures can progress to a linear stress fracture and a periosteal or endosteal response [23]. Stress fractures of the foot and ankle are common in sports in which there is
Interdigital neuromas
Interdigital neuromas are a common cause of forefoot pain in the athlete. Constrictive footwear found in sports such as ice hockey, cycling, and soccer may predispose to the development of interdigital neuroma symptoms. In these sports, the interface between the foot and playing surface is so important that the athlete may forgo comfort to obtain a sense that the foot and athletic surface are one.
The diagnosis is usually made by taking a thorough patient history and performing a physical
Midfoot sprain
Midfoot injuries are uncommon but can be devastating to the athlete, particularly when they are misdiagnosed. Such injuries can end a season or even a career, so careful examination, a high level of clinical suspicion, and appropriate diagnostic tests are crucial to obtain a correct diagnosis and to initiate an appropriate treatment plan. Anatomic restoration of displaced fracture/dislocation of the tarsometatarsal junction of the foot is essential because even minor disruptions of this joint
Ankle sprain
Ankle injuries are among the most common sports-related injuries and represent a significant source of persistent pain and disability for the athlete. Injury not only involves the osseous and ligamentous structures of the ankle but may also include tendinous or other osseous injuries. The Ottawa Ankle Rules were developed to aid the physician in determining whether radiographs are required in acute ankle injuries [43]. A number of studies have validated the use of the Ottawa Ankle Rules [44],
Summary
Foot and ankle injuries are among the most common of all sports-related injuries. Many injuries are simplistic from a diagnostic standpoint, whereas others require a high level of suspicion and the use of appropriate diagnostic imaging modalities. Whether a professional athlete or a weekend warrior, all athletes want minimal disruption to their sporting activity and a quick return to competition. An accurate diagnosis aids in the development of an appropriate rehabilitation program and in
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Cited by (8)
MR Imaging of the Midfoot Including Chopart and Lisfranc Joint Complexes
2017, Magnetic Resonance Imaging Clinics of North AmericaCitation Excerpt :Extensive soft tissue edema may delay the diagnosis in these patients.29,30,35 Low-energy trauma injuries, also called midfoot sprains, are most frequently sports-related and can be due to indirect forces.30,36 In 1909, Quenu and Kuss classified Lisfranc injuries into 3 categories: homolateral, isolated, and divergent.
Emergency Imaging of Foot Trauma
2016, Seminars in RoentgenologyCitation Excerpt :This modality is typically reserved for evaluating soft tissue structures, such as the Lisfranc ligament and hallux metatarsophalangeal sesamoid complex plantar plate, and occult stress fractures.8 Similarly, nuclear imaging has no role in the acute trauma setting, although it may be used to identify stress fractures.9 A role for sonography in the evaluation of foot trauma when radiographs are negative has been suggested,10 but widespread acceptance of this modality for fracture detection is lacking.
Answer to 'A 28-year-old snowboarder presents with chronic ankle pain'
2015, British Journal of Sports MedicineStress fractures in the foot and ankle of athletes
2014, Revista da Associacao Medica BrasileiraFractures and dislocations of the midfoot and forefoot
2014, Rockwood, Green, and Wilkins Fractures in Adults and Children: Eighth EditionNot just a sprain: 4 foot and ankle injuries you may be missing
2012, Journal of Family Practice