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Football related injury diagnosis
Football injuries and imaging technology In a 2nd paper, Dr. Towers and his colleagues identified
for the 1st time an indirect sign of syndesmotic tear, a frequently
misdiagnosed injury more commonly known as high ankle sprain. Currently, the
condition is most commonly diagnosed by uncomfortable physical examination
of the syndesmosis, a large ligament above the ankle.
"In syndesmotic tear, the biggest ligament that holds the fibula and tibia together is injured," Dr. Towers explained. "The fibula can move away from the tibia, and the cylindrical groove which forms the ankle can widen under load. The problem as we see it is that routine x-rays may not discover it, because it’s not badly misaligned. It's during athletic activity when the injury becomes most apparent." Left undiagnosed, high ankle sprain can impede an athlete's performance and eventually lead to arthritis. "The treatment for high ankle sprain is different and generally longer than for a typical ankle sprain," Dr. Towers said. "If it is not diagnosed, and you send somebody out to play, the ligaments heal improperly, the ankle doesn’t fit as tightly as it should, and often the result is arthritis." |
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The researchers used MRI and x-rays to study eighteen candidates for the 2005 professional football draft who were found to have a history of high ankle sprain. 14 x-rays showed an abnormal growth of new bone, known as periostosis, at the lower part of the tibia, the large bone between the foot and the knee. 2 MRI examinations revealed abnormal swelling due to fluid at the same site. According to Dr. Towers, this periostosis provides doctors with an indirect sign of high ankle sprain that is decisive in diagnosing this difficult-to-detect injury. "Even if I don't have MR images that include the entire syndesmosis, which goes into the lower leg," Dr. Towers said, "if I look at an ankle and see this posterior periostosis, I can now be fairly sure of a syndesmotic injury." |
Co-authors on both studies are Derek Armfield, M.D., John Norwig, M.E.D., from University of Pittsburgh Medical Center, James Bradley, M.D. and Kenneth Buckwalter, M.D., from Indiana University Medical Center, which coordinates imaging for the professional football draft.
Read the first part of this article.
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