MAGNETIC RESONANCE IMAGING IN TRAUMATIC INJURIES OF THE ANKLE JOINT IN CHILDREN



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Abstract

Introduction. Sprain of the ankle joint is one of the most common injuries in children during sport activities. Purpose. To define MRI diagnostic value in ankle joint injuries. Material and methods. 30 patients , 18 boys and 12 girls aged 8-17 ( average age 14.6 years), were enrolled into the study. 20 of them (66.7%) were 12-14 years old, 3 (10%) - < 10 years old and 7 (23.3 %) - > 14 years old. A Philips AchievadStream 3.0 Tesla scanner was used for MRI examination. Results. MRI findings showed that 17 (56.7%) patients had damage of the anterior talofibular ligament; 8 patients had avulsion of bone fragments of the lateral ankle; 9 patients (30.0%) had partial deltoid ligament injuries. Complete rupture of ligaments was rare and was seen only in two patients (6.7%). Conclusion. MRI is a method of choice in assessing ankle injuries due to high contrast of soft tissues, high resolution and multi-planar potentials. MRI is especially useful in examining soft ankle tissue structures such as tendons, ligaments, nerves and fascia, as well as in revealing hidden / subtle bone damage.

About the authors

N. Yu. Serova

Clinical and Research Institute of Emergency Pediatric Surgery and Trauma

Author for correspondence.
Email: noemail@neicon.ru
Россия

T. A. Akhadov

Clinical and Research Institute of Emergency Pediatric Surgery and Trauma

Email: noemail@neicon.ru
Россия

I. A. Melnikov

Clinical and Research Institute of Emergency Pediatric Surgery and Trauma

Email: noemail@neicon.ru
Россия

O. V. Bozhko

Clinical and Research Institute of Emergency Pediatric Surgery and Trauma

Email: noemail@neicon.ru
Россия

N. A. Semenova

Clinical and Research Institute of Emergency Pediatric Surgery and Trauma

Email: noemail@neicon.ru
Россия

S. O. Nikishov

Clinical and Research Institute of Emergency Pediatric Surgery and Trauma

Email: noemail@neicon.ru
Россия

D. M. Dmitrenko

Clinical and Research Institute of Emergency Pediatric Surgery and Trauma

Email: noemail@neicon.ru
Россия

A. V. Manzhurtsev

Clinical and Research Institute of Emergency Pediatric Surgery and Trauma

Email: noemail@neicon.ru
Россия

T. D. Kostikova

Clinical and Research Institute of Emergency Pediatric Surgery and Trauma

Email: noemail@neicon.ru
Россия

M. I. Akhlebinina

Clinical and Research Institute of Emergency Pediatric Surgery and Trauma

Email: noemail@neicon.ru
Россия

M. V. Ublinsky

Clinical and Research Institute of Emergency Pediatric Surgery and Trauma

Email: maxublinsk@mail.ru
Россия

References

  1. Bateni C., Bindra J., Haus B. MRI of sports injuries in children and adolescents: what’s different from adults. Current Radiology Reports. 2014; 2(5): 45.
  2. Kay R.M., Matthys G.A. Pediatric ankle fractures: evaluation and treatment. J Am Acad Orthop Surg. 2001; 9(4): 268-78.
  3. Cheng Y., Cai Y., Wang Y. Value of ultrasonography for detecting chronic injury of the lateral ligaments of the ankle joint compared with ultrasonography findings. Br J Radiol. 2014; 87(1033): 20130406.
  4. Junge A., Engebretsen L., Mountjoy M.L., Alonso J.M., Renstrom P.A., Aubry M.J., et al. Sports injuries during the Summer Olympic Games 2008. Am J Sports Med. 2009; 37(11) : 2165-7.
  5. Petersen W., Rembitzki I. V., Koppenburg A. G., Ellermann A., Liebau C., Bruggeman G.P., et al. Best Treatment of acute ankle ligament injuries: a systematic review. Arch Orthop Trauma Surg. 2013; 133(8): 1129-41.
  6. Kaplan L.D., Jost P.W., Honkamp N., Norwig J., West R., Bradley J.P. Incidence and variance of foot and ankle injuries in elite college football players. Am J Orthop (Belle Mead NJ). 2011; 40: 40-4.
  7. Luciano Ade P., Lara L.C. Epidemiological study of foot and ankle injuries in recreational sports. Acta Ortop Bras. 2012; 20: 339-42.
  8. Hunt K.J., Hurwit D., Robell K., Gatewood C., Botser I.B., Matheson G. Incidence and Epidemiology of Foot and Ankle Injuries in Elite Collegiate Athletes. Am J Sports Med. 2017;45(2): 426-33.
  9. Oestreic A.E., Bhojwani N. Stress fractures of ankle and wrist in childhood: nature and frequency. Pediatric Radiology. 2010; 40(8): 1387-9.
  10. Mizuta T., Benson W.M., Foster B.K., Paterson D.C., Morris L.L. Statistical analysis of the incidence of physeal injuries. J Pediatr Orthop. 1987; 7: 518-23.
  11. Fong D.T., Hong Y., Chan L.K., Yung P.S., Chan K.M. A systematic review on ankle injury and ankle sprain in sports. Sports Med. 2007; 37(1): 73-94.
  12. Sellon E., Robinson P. MR Imaging of Impingement and Entrapment Syndromes of the Foot and Ankle. Magn Reson Imaging Clin N Am. 2017; 25(1): 145-58.
  13. Mauntel T.C., Wikstrom E.A., Roos K.G., Djoko A., Dompier T.P., Kerr Z.Y. The Epidemiology of High Ankle Sprains in National Collegiate Athletic Association Sport. Am J Sports Med. 2017; 45(9): 2156-63.
  14. Anderson S.A., Li X., Franklin P., Wixted J.J. Ankle fractures in the elderly: initial and long-term outcomes. Injury. 2007; 38: 2-59.
  15. Jonckheer P., Willems T., De Ridder R., Paulus D., Henningsen H., SanMiguel L., et al. Evaluating fracture risk in acute ankle sprains: Any news since the Ottawa Ankle Rules? A systematic review. Eur J Gen Pract. 2016; 22(1) :31-41.
  16. Gaebler C., Kukla C., Breitenseher M.J., Nellas Z.J., Mittlboeck M., Trattnig S., et al. Diagnosis of lateral ankle ligament injuries. Comparison between talar tilt, MRI and operative findings in 112 athletes. Acta Orthop Scand. 1997; 68(3): 286-90.
  17. Polzer H., Kanz K.G., Prall W.C., Haasters F., Ockert B., Mutschler W., et al. Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm. Orthop Rev (Pavia). 2012;4(1): e5.
  18. Cheung Y., Rosenberg Z.S. MR imaging of ligamentous abnormalities of the ankle and foot. Magn Reson Imaging Clin N Am. 2001; 9(3): 507-31.
  19. Oae K., Takao M., Naito K., Uchio Y., Kono T., Ishida J., et al. Injury of the tibiofibular syndesmosis: value of MR imaging for diagnosis. Radiology. 2003; 227(1): 155-61.
  20. Sofka C.M. Technical Considerations: Best Practices for MR Imaging of the Foot and Ankle. Magn Reson Imaging Clin N Am. 2017; 25(1): 1-10.
  21. Gold G.E., Busse R.F., Beehler C., Han E., Brau A.C., Beatty P.J., et al. Isotropic MRI of the knee with 3D fast spin-echo extended echo-train acquisition (XETA): initial experience. AJR Am J Roentgenol. 2007; 188: 1287.
  22. Sharma G.K., Dhillon M.S., Dhatt S.S. The influence of foot and ankle injury patterns and treatment delays on outcomes in a tertiary hospital; a one-year prospective observation. Foot. 2016; 26: 48.
  23. Kijowski R., Davis K.W., Woods M.A., Lindstom M.J., De Smet A.A., Gold G.E., et al. Knee joint: comprehensive assessment with 3D isotropic resolution fast spin-echo MR imaging-diagnostic performance compared with that of conventional MR imaging at 3.0 T. Radiology. 2009; 252: 486.
  24. Busse R.F., Brau A.C., Vu A., Michelich C.R., Bayram E., Kijowski R., et al. Effects of refocusing flip angle modulation and view ordering in 3D fast spin echo. Magn Reson Med. 2008; 60: 640.
  25. Yi J., Cha J.G., Lee Y.K., Lee B.R., Jeon C.H. MRI of the anterior talofibular ligament, talar cartilage and os subfibulare: Comparison of isotropic resolution 3D and conventional 2D T2-weighted fast spin-echo sequences at 3.0 T. Skeletal Radiol. 2016.; 45(7): 899-908.
  26. Sookur P.A., Naraghi A.M., Bleakney R.R., Jalan R., Chan O., White L.M. Accessory muscles: anatomy, symptoms, and radiologic evaluation. Radiographics. 2008; 28(2): 481-99.
  27. Nelson A. J., Collins C.L., Yard E.E., Fields S.K., Comstock R.D. Ankle injuries among United States high school sports athletes, 2005-2006. Journal of athletic training. 2007; 42(3): 381.
  28. Huebscher M., Zech A., Pfeifer K., Hansel F., Vogt L., Banzer W.E. Neuromuscular training for sports injury prevention: a systematic review. Medicine & Science in Sports & Exercise. 2010; 42 (3): 413-21.
  29. Johnson T., Fink C., Schonberg S.O., Reiser M.F. (ed.). Dual energy CT in clinical practice. Springer Science & Business Media, 2011.
  30. Hubbard T. J., Hicks-Little C. A. Ankle ligament healing after an acute ankle sprain: an evidence-based approach. Journal of athletic training. 2008: 43(5); 523-9.
  31. Roos K.G., Kerr Z.Y., Mauntel T.C., Djoko A., Dompier T.P., Wikstrom E.A. The Epidemiology of Lateral Ligament Complex Ankle Sprains in National Collegiate Athletic Association Sports. Am J Sports Med. 2017; 45(1): 201-9.
  32. Mosher T.J., Kransdorf M.J., Adler R., Appel M., Beaman F.D., Bernard S.A., et al. ACR Appropriateness Criteria acute trauma to the ankle. J Am Coll Radiol. 2015; 12(3): 221-7.
  33. Perrich K.D., Goodwin D.W., Hecht P.J., Cheung Y. Ankle Ligaments on MRI: Appearance of Normal and Injured Ligaments. American Journal of Roentgenology. 2009; 193(3): 687-95.
  34. Beynnon B.D., Renström P.A., Haugh L., Uh B.S., Barker H. A prospective, randomized clinical investigation of the treatment of first-time ankle sprains. Am J Sports Med. 2006; 34(9): 1401-12.

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