Exams for Common Injuries of the Athlete
The sports doctor has multiple examination techniques in which it is sometimes difficult to make a judicious choice indeed
Medical Imaging: The Fracture of Fatigue
The stress fracture is a frequently encountered condition in athletes due to hyper bone and tendon-muscle load. At the beginning phase, at the stage of initial intense pain, standard pictures are usually normal.
The diagnosis of stress fracture on standard images is based, on the one hand, on the detection of a reactionary periostosis, on the other hand and above all by the discovery of a visible callus in the form of a small hyperdense band. , most often perpendicular to the axes of force.
The scanner is readily negative at the very beginning, but it shows the fracture trait more easily and more early than the standard snapshot, especially when this fracture sits in anatomically complex sites (mediotarysis, etc.). The scintigraphy is positive very early, but lacks specificity.
MRI is the examination that shows, on the one hand, the edema of the gypsy moth in the form of a high signal in T2 and the fracture line itself visible in the form of a hyposignal band within this hypersignal. MRI test scan at the very beginning may only show edema of the gypsy moth without identifying the fracture line itself.
Bone scintigraphy reveals hyper-fixation confirming the diagnosis at first, but without following its evolution.
Tendon diseases
For tendon diseases, the two standard examinations are ultrasound and MRI. In ultrasound test cost in Delhi, a normal tendon appears as a hyperechoic band, fibrillar structure, surrounded by two hyperechoic lines in the longitudinal plane.
Breaks
The total rupture is characterized in ultrasound as in MRI by a complete interruption of the tendinous fibers. In ultrasound, dynamic tests show the immobility of one part of the tendon compared to the other. The fissure syndrome is characterized by a partial interruption of the tendon or dissection of the fibers in the longitudinal plane.
Tendinopathies
They are characterized by a thickening of the tendon that can be either global or focal. In ultrasound, we will look for nodules often seats Doppler hyper-vascularization. There are sometimes small intratendinous calcifications. In MRI, these nodules are well visualized after injection of gadolinium in the form of well-limited zones in hypersignal in T1 with suppression of fat.
Dislocations and subluxations
Ultrasound for dynamic maneuvers clearly shows these dislocations or subluxations, tendons being located outside their usual anatomical path (dislocation of lateral peroneal tendons or dislocation of the tendon of the long biceps for example). MRI can only highlight permanent dislocations because dynamic tests are difficult to perform in MRI.
Tenosynovitis
They are characterized by the presence of fluid in the tendon sheath and by small phenomena of connection between the sheath and the tendon itself. The presence of excess fluid in the tendon sheath by ultrasound or MRI test labs in Delhi should be assessed depending on the site. Indeed, some tendinous sheaths are readily filled with fluid (the sheath of the flexor clean of the big toe for example) without this has a significant pathological value.
