Serial Ultrasonography for the Assessment of Healing of Lower Extremity Bone Stress Injury and Correlation With Return to Sport/Exercise.

IF 2.7 2区医学 Q1 SPORT SCIENCES

Sports Health-A Multidisciplinary Approach Pub Date : 2024-09-01 Epub Date: 2024-02-27 DOI:10.1177/19417381241231590

Brett G Toresdahl, Justin Conway, Theodore T Miller, Marci A Goolsby, Christian S Geannette, Brianna Quijano, Lisa R Callahan

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引用次数: 0

Abstract

Background: Lower extremity bone stress injuries (BSIs) are common among athletes who participate in high-impact activities. Conventional imaging is limited in assessing healing of BSIs.

Hypothesis: Serial ultrasonography (US) can identify changes in appearance of lower extremity BSIs over time that can be correlated with symptoms and return to exercise/sport.

Study design: Cohort observational study.

Level of evidence: Level 3.

Methods: Adults 18 to 50 years old with a recent exercise-associated BSI of distal tibia/fibula or metatarsals diagnosed by magnetic resonance imaging (MRI) were enrolled. US was performed every 2 weeks for 12 weeks. The sonographic appearance (soft tissue edema, periosteal reaction, hyperemia on power Doppler, callus) was correlated with the numerical rating scale (NRS) for pain and ability to return to sport/exercise.

Results: A total of 30 patients were enrolled (mean age, 35.3 ± 7.7 years; 21 [70.0%] female). The tibia was most frequently affected (n = 15, 50.0%), followed by metatarsals (n = 14, 46.7%) and fibula (n = 1, 3.3%). At week 4, 25 of 30 (83.3%) had at least 1 US finding associated with the BSI. The degree of hyperemia was correlated with NRS at weeks 4 and 6 (Spearman correlations [ρ] 0.45 [0.09, 0.69] and 0.42 [0.07, 0.67], respectively), as well as return to sport/exercise at week 6 (ρ -0.45 [-0.68, -0.09]). US soft tissue edema was also correlated with NRS at week 6 (ρ 0.38 [0.02, 0.65]).

Conclusion: Serial US of lower extremity BSIs can provide objective measures of healing. US findings were correlated with clinical outcomes at multiple timepoints.

Clinical relevance: US may have advantages over conventional imaging for monitoring healing of lower extremity BSIs. Further research is needed to better understand the prognostic value of these sonographic indicators of BSI healing and role in assessing readiness for return to sport/exercise.

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用于评估下肢骨应力损伤愈合情况的连续超声波检查以及与恢复运动/锻炼的相关性。

背景：下肢骨应力损伤（BSI）在参加高冲击活动的运动员中很常见。传统成像技术在评估 BSI 愈合方面存在局限性：研究设计：队列观察研究：研究设计：队列观察研究：证据等级：3级：研究对象：年龄在18至50岁之间、近期经磁共振成像（MRI）诊断为运动相关性胫骨远端/腓骨或跖骨BSI的成年人。每两周进行一次超声波检查，持续 12 周。声学外观（软组织水肿、骨膜反应、功率多普勒显示的充血、胼胝）与疼痛和恢复运动/锻炼能力的数字评分表（NRS）相关联：共有 30 名患者入选（平均年龄为 35.3 ± 7.7 岁；21 名[70.0%]女性）。最常受影响的是胫骨（15 人，50.0%），其次是跖骨（14 人，46.7%）和腓骨（1 人，3.3%）。第 4 周时，30 人中有 25 人（83.3%）至少有一项 US 发现与 BSI 相关。充血程度与第 4 周和第 6 周的 NRS 相关（Spearman 相关性 [ρ] 分别为 0.45 [0.09, 0.69] 和 0.42 [0.07, 0.67]），也与第 6 周恢复运动/锻炼相关（ρ -0.45 [-0.68, -0.09]）。US软组织水肿也与第6周的NRS相关（ρ 0.38 [0.02, 0.65]）：结论：对下肢 BSI 进行连续 US 检查可客观衡量愈合情况。结论：连续 US 可提供客观的愈合测量指标，US 结果与多个时间点的临床结果相关：临床意义：在监测下肢 BSI 愈合方面，US 可能比传统成像更有优势。临床意义：在监测下肢BSI愈合方面，超声成像可能比传统成像更有优势。需要进一步研究，以更好地了解这些超声成像指标对BSI愈合的预后价值以及在评估恢复运动/锻炼的准备情况方面的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sports Health-A Multidisciplinary Approach Medicine-Orthopedics and Sports Medicine

CiteScore

6.90

自引率

9.10%

发文量

101

期刊介绍： Sports Health: A Multidisciplinary Approach is an indispensable resource for all medical professionals involved in the training and care of the competitive or recreational athlete, including primary care physicians, orthopaedic surgeons, physical therapists, athletic trainers and other medical and health care professionals. Published bimonthly, Sports Health is a collaborative publication from the American Orthopaedic Society for Sports Medicine (AOSSM), the American Medical Society for Sports Medicine (AMSSM), the National Athletic Trainers’ Association (NATA), and the Sports Physical Therapy Section (SPTS). The journal publishes review articles, original research articles, case studies, images, short updates, legal briefs, editorials, and letters to the editor. Topics include: -Sports Injury and Treatment -Care of the Athlete -Athlete Rehabilitation -Medical Issues in the Athlete -Surgical Techniques in Sports Medicine -Case Studies in Sports Medicine -Images in Sports Medicine -Legal Issues -Pediatric Athletes -General Sports Trauma -Sports Psychology