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Imaging of Common Injuries Encountered in Sports Medicine

Imaging of Common Injuries Encountered in Sports Medicine. Tommy McCullough April 3, 2008 M-IV USC School of Medicine. History & Physical. Type of activity Mechanism of injury Pain? Swelling? Duration of symptoms. History & Physical. Inspection – ecchymosis, edema, joint effusions

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Imaging of Common Injuries Encountered in Sports Medicine

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  1. Imaging of Common Injuries Encountered in Sports Medicine Tommy McCullough April 3, 2008 M-IV USC School of Medicine

  2. History & Physical • Type of activity • Mechanism of injury • Pain? • Swelling? • Duration of symptoms

  3. History & Physical • Inspection – ecchymosis, edema, joint effusions • Movement – range of motion • Palpation – tenderness, instability • Tests – injury specific based on findings • Imaging – also depends on suspected injury

  4. Shoulder • Rotator cuff • Labrum • A-C joint • Clavicle • Dislocation

  5. Rotator Cuff MRI normal shoulder

  6. Rotator Cuff Rotator cuff tear

  7. Labrum SLAP tear

  8. Acromioclavicular Joint Rockwood Classification:          - type I:                    - sprain of joint with out a complete tear of either ligament          - type II:                    - tear of AC ligaments w/ coracoclavicular ligaments intact;                    - will not show marked elevation of lateral end of clavicle;          - type III:                    - in this injury both AC & CC ligaments are torn;                    - > 5 mm elevation of AC joint w/o weights is consistent w/ severe type II or a type III injury;                    - need to distinguish this from type III clavicular fracture          - type IV:                    - distal clavicle impaled posteriorly into trapezial fascia;          - type V: - distal end of clavicle displaced inferiorly

  9. AC Joint Type III separation

  10. AC Joint

  11. Clavicle Fracture of middle 1/3 of clavicle

  12. Shoulder Dislocation Anterior dislocation

  13. Knee • ACL • PCL • MCL • LCL • Meniscus

  14. Anterior Cruciate Ligament MRI normal ACL

  15. Anterior Cruciate Ligament MRI ACL tear

  16. Anterior Cruciate Ligament MRI ACL tear

  17. Anterior Cruciate Ligament “Bruise” in bone with ACL tear

  18. Segond Fracture Associated with ACL tear

  19. Posterior Cruciate Ligament MRI normal PCL

  20. Posterior Cruciate Ligament MRI PCL tear

  21. Posterior Sag Sign Sign of PCL rupture

  22. Medial Collateral Ligament MRI normal MCL

  23. Medial Collateral Ligament MRI MCL tear

  24. Lateral Collateral Ligament MRI normal LCL

  25. Meniscus MRI normal meniscus

  26. Meniscus MRI meniscus tear

  27. Meniscus MRI meniscus tear

  28. Bucket Handle Tear Double PCL sign

  29. Bucket Handle Tear Frontal view of bucket handle tear

  30. Meniscus Tears

  31. Others • Ankle – Achilles tear, tendonitis • Leg – stress fractures • Foot – fractures • Elbow – Ulnar collateral ligament • Spine – spondylolysis, spondylolysthesis

  32. Achilles Tendon MRI normal calcaneal tendon

  33. Tibial Stress Fracture

  34. Fibular Stress Fracture

  35. Metatarsal Stress Fracture Periosteal reaction

  36. Metatarsal Stress Fracture

  37. Metatarsal Stress fracture

  38. Jones Fracture

  39. Jones Fracture After surgical repair

  40. Ulnar Collateral Ligament MRI UCL tear

  41. Spondylolysis

  42. Spondylolysis

  43. Spondylolisthesis

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