Foot and Ankle Imaging in the Athlete

The foot in multistage ultra-marathon runners: experience in a cohort study of 22 participants of the Trans Europe Footrace Project with mobile MRI

“…While reliable reports on ultra-marathon effects are lacking, the present literature describes overuse injuries2 3 in endurance sport and shows the Achilles tendon (AT) to be a structure of high risk because it is regularly injured in sports 45 Also, ankle and hind foot injuries are frequent among athletes,6 7 with visible bone oedema even in asymptomatic individuals increasing their exposure 8. Other reports show high rates of fatigue fractures in army recruits after exerting marches 9…”

Answer to ‘A 28-year-old snowboarder presents with chronic ankle pain’

“…CT is critical in providing exact measurements of the bony component of the osteochondral lesion to facilitate meticulous preoperative planning. However, owing to the insensitivity of CT for identifying cartilage damage and subtle injury to cancellous bone, the place of CT as a standalone modality in the initial diagnosis of osteochondral lesions has been questioned 10 11…”

Stress fractures in the foot and ankle of athletes

“…13 Follow-up using computerized tomography or magnetic resonance imaging may also be useful to monitor healing of the stress fractures and determining if there is a delay in healing that could require surgical intervention (D). 6 Recommendation In cases of suspected stress fractures, plain radiography of the site of pain should be requested, with diagnosis in the majority of cases via more sensitive and specific imaging exams (magnetic resonance imaging).…”

“…Basketball athletes have a prominence of the medial malleolus, navicular bone and metatarsal stress fractures, while for footballers lesser metatarsal fractures are more common. 6,7,8 From a biomechanical point of view, fatigue fractures are the result of specific, cyclical and repetitive muscle action until exhaustion, with load transfer to the bone exceeding its adaptation capacity. 8,10 The shear and compression forces stimulate bone transformation according to Wolff's law, that is, the compression forces promote osteoblast activity and bone deposition leading to a strengthening of bone structures, adapting to the applied load, while shear forces lead to the reverse process of bone resorption by stimulating osteoclast activity.…”

“…Even after some days of rest, returning to activities too early leads to recurrence of the pain (D). [4][5][6]8 Recommendation Stress fractures in the feet of athletes should be suspected in the presence of insidious pain associated with increased exercise intensity.…”