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Role of MRI in Prevention of Metatarsal Stress Fractures in Collegiate Basketball Players AJR 2006; 186:255-258
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OBJECTIVE. Metatarsal stress fractures are common and represent debilitating and potentially season-ending injuries for basketball players. Bone marrow edema is readily visualized on MRI and can be a sign of stress changes.
Twenty-six asymptomatic male National Collegiate Athletic Association basketball players were imaged before the 2003-2004 season and 14 players were reimaged after the conclusion of the season with a screening study of long- and short-axis fat-suppressed T2-weighted images (TR/effective TE, 3,500/56) to identify bone marrow edema in the metatarsals.
CONCLUSION. Six (12%) of 52 feet showed a signal indicating bone marrow edema in the metatarsals. MRI depicts bone marrow edema in the feet before a fracture becomes evident. Identification of this edema may reveal stress changes, allowing early treatment and prevention of debilitating stress fractures.
Stress fractures in athletes. role of magnetic resonance imaging in predicting injury morbidity
Maquirriain J, Ghisi JP. Medicina (B Aires). 2007;67(3):262-70.
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Magnetic resonance imaging is a useful tool for stress fractures (SF) diagnosis, allowing the estimation of injury severity. The aim of this study was to determine the relation between the severity of SF in athletes determined by magnetic resonance imaging and the morbidity estimated as the time to return to sport. Thirty-four cases of stress fractures, (29 athletes; 12 female, 17 male; age 26.3 +/- 12.5), were studied by radiographs and magnetic resonance imaging. Injuries were classified according to Arendt's scale and they were analyzed according to site, activity level, delay in diagnosis and time needed to return to sports. The tibia was the most affected bone (n=12; 35.2%), followed by the tarsal navicular (n=5; 14.7%), and the metatarsals (n=4; 11.7%). Injury severity according to magnetic resonance imaging appearance was: grade 1=14.7%; grade 2=14.7%; grade 3=38.2%; grade 4=32.4%. The main finding was the positive significant correlation between injury severity and recovery time (r=0.66, p=0.0002). In conclusion, significant correlation exists between stress fracture injury severity determined by magnetic resonance image and recovery time in athletes. The use of a systematic graded magnetic resonance image evaluation may assist the physician to define clinical management, supervise the rehabilitation program and estimate the return to sport activity