MRI features of and factors related to ankle injuries in asymptomatic amateur marathon runners

Abstract

Objective To analyze the MRI manifestations of and factors related to ankle injuries in asymptomatic amateur marathon runners. Materials and methods A total of 113 amateur marathon runners without any ankle joint symptoms were recruited. Each participant was asked to complete a questionnaire at the beginning of the study and underwent MRI of the ankle. The MRI manifestations of ankle injuries were summarized, and binary logistic regression analysis was applied to analyze the factors related to ankle injuries. Results The main MRI features were bone marrow edema-like signal intensity, peritendinous effusion, and partial lateral collateral ligament injury. Others included Achilles tendinopathy, cyst-like lesions, osteochondral lesions, and subcutaneous soft tissue edema. The risk factor for bone marrow edema-like signal intensity in amateur marathon runners was a rearfoot strike pattern ( p = 0.028, OR = 1.172); the risk factors for peritendinous effusion were a higher weekly running distance ( p = 0.013, OR = 1.685) and increased running years ( p = 0.039, OR = 1.113), whereas a rearfoot strike pattern ( p = 0.005, OR = 0.831) was a protective factor for peritendinous effusion; the risk factor for Achilles tendinopathy was increased age ( p = 0.008, OR = 1.412); the risk factors for anterior talofibular ligament injury were a rearfoot strike pattern ( p = 0.017, OR = 1.346) and higher weekly running distance ( p = 0.022, OR = 1.171); and the factors for calcaneofibular ligament injury were a higher weekly running distance ( p = 0.029, OR = 1.570) and rearfoot strike pattern ( p = 0.035, OR = 1.463). Conclusion The main MRI features of asymptomatic amateur marathon runners are bone marrow edema-like signal intensity, peritendinous effusion, and partial lateral collateral ligament injury. In addition, increased age, increased running years, higher weekly running distance, and different foot strike patterns are risk factors for ankle injuries.

Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care

“…129 In ankle MRI of asymptomatic amateur marathon runners, up to 80% may show tendon changes, 48% ligament injuries and 27% achilles tendinopathy. 130 Up to 37% of people may have incidental 'abnormal' anterior talofibular ligaments. 131 132 Achilles tendon changes may be seen in up to 63% of asymptomatic individuals, and retrocalcaneal bursal changes in 68% of runners.…”

Asymptomatic Bone Marrow Edema in Weight-bearing Bones in Athletes and Military Trainees: A Systematic Literature Review

“…Tenforde et al 6 used a modified grading system developed specifically for BME, which was proposed by Fredericson and Arendt and Yao et al. 17 used a grading system developed by Lazzarini et al Varkas et al 7 used the Spondyloarthritis Research Consortium of Canada (SPARCC) grading system, which is specific to symptomatic sacroiliitis. Horga et al 20 used the scoring of hip osteoarthritis with an MRI (SHOMRI) grading system, which contains a subcategory describing BME severity.…”

“…So it can be inferred that athletic individuals can continue participation with low risk and not be restricted with respect to activities in the shorter term of a season or year. Despite being only discussed by one study 17 , it is worth noting the impact that biomechanics, such as foot strike pattern, may have on BME-like MRI signals. Specifically, a non-rearfoot strike pattern is implicated in a lower ground reaction force compared to a rearfoot strike pattern, and therefore may be associated with less repetitive pressure injury to the ankle joint 17 28 .…”

Bone marrow edema of the medioplantar talar head is associated with severe ligamentous injury in ankle sprain

“…In this case, we often see stress reactions or fractures of the tarsal bones [ 12 ]. There is no information in the literature about isolated finding in the talar head so far [ 13 ]. Further reasons, not trauma-associated, include immobilization, complex regional pain syndrome, bone infarcts, osteoarthritis, inflammatory arthritis, neuroarthropathy, and transient osteoporosis, often seen with more subchondral diffuse and multifocal distribution [7; 16; 17], not as in our study with typical localized edema.…”