Magnetic resonance imaging of a sports injury of the lower extremities in children

Abstract

Introduction. The number of acute and stressful injuries has been increasing in recent years. Injuries of the musculoskeletal system in children seeking emergency care account for 41%, while children aged from 5 to 17 years with chronic sports injuries account for 53% who need medical attention. The lower extremity is the most frequently affected part of patients aged from 5 to 18 years, which is about 60% of all injuries. Aim of the study. To show the possibilities of magnetic resonance imaging in the diagnosis of sports injuries of lower extremities in children. Materials and methods. MRI was performed on a scanner with a magnetic field strength of 3 T to obtain multi-planar STIR, T1-, T2- and PD-weighted images (WI) SE and GE in axial, oblique frontal and sagittal projections with a slice thickness of 4 mm, as well as 2D and 3D isotropic images that were used to obtain images with contrast gain. Specialized coils were used for MRI. MRI was performed in case of damage to the hip (n = 19), knee (n = 329), and ankle joints (n = 32). Results. Studies of the hip were limited to sports muscle injury - muscle strain due to forced contractile load (75.8%) and muscle bruises (24.2%). According to the MRI results, 320 children with knee injury were diagnosed with ACL ruptures, in 67% - complete (n = 214), 33% (n = 106) - partial. Eight (3.7%) of 214 athletes had isolated full breaks in ACL; the remaining 206 were associated with damage to other structures of the knee joint. ACL ruptures were accompanied in all 320 cases of hemarthrosis. Of 30 patients with an ankle injury, 17 had an anterior talofibular ligament (56.7%), in 8 cases with an avulsion of bone fragments from the lateral ankle. Partial deltoid ligament injuries were detected in 9 patients (30.0%); complete ruptures were rare and were observed in only two patients (6.7%). Conclusion. Among imaging methods, MRI plays a decisive role in the diagnosis of sports injuries in children.