Sports Injuries at the Rio de Janeiro 2016 Summer Olympics: Use of Diagnostic Imaging Services

Utilization of Imaging for Severe Injuries at the Beijing 2022 Winter Olympic Games

Purpose: In order to better understand the imaging of severe trauma in sport, this study describes the imaging modalities utilized to image athletes who experienced severe traumatic injuries at the Beijing Winter Olympic Games 2022, the distribution of these modalities in relation to the sporting facilities, and the types of injuries imaged in each sport. Methods: This is a retrospective analysis with descriptive tables and figures, performed on a single population (athletes of the Beijing Winter Olympic Games 2022). Results: Of the 2871 athletes in the Beijing Winter Olympic Games, there were 40 athletes with severe injuries who underwent medical imaging. MRI was used more often than Radiography or CT. Athletes at venues without MRI on site had to be transferred to adjacent hospitals for care. Alpine and Freestyle skiing athletes experienced the majority of severe traumatic injuries at this Olympic Games, and the majority of injuries were to the lower limb. Conclusions: Access to medical imaging for severely injured athletes is a critical consideration in the organization of any sporting event. MRI in particular is highly utilized in this population.

Management of radiology services during the 2022 FIFA football (soccer) World Cup

Diagnostic imaging is the predominant medical service sought for the assessment and staging of musculoskeletal injuries in professional sports events. During the 2022 FIFA Football (soccer) World Cup, a centralized medical care infrastructure was established. This article provides a comprehensive account of the radiological services implemented during this event, encompassing the deployment of equipment and human resources, the structuring of workflows to uphold athlete confidentiality, and initiatives aimed at enhancing communication. Communication channels were refined through radiology consultations held with national teams' health care providers and the adoption of audiovisual reports available in multiple languages, which could be accessed remotely by team physicians. Our established framework can be replicated in international professional football events for seamless integration and efficacy.

Imaging-detected sports injuries and imaging-guided interventions in athletes during the 2022 FIFA football (soccer) World Cup

OBJECTIVE

To describe imaging-detected musculoskeletal injuries and image-guided interventional procedures during the 2022 FIFA football (soccer) World Cup.

MATERIALS AND METHODS

Retrospective analysis of all radiologic examinations performed in a central medical facility for athletes was performed by two board certified musculoskeletal radiologists. Data on muscle, tendon, ligament, cartilage, and bone injuries were collected according to imaging modality and body part.

RESULTS

A total of 143 radiology examinations in 94 athletes were evaluated at the central medical facility. Magnetic resonance imaging (MRI) was the most utilized modality (67%), followed by radiography (12%), ultrasonography (9%), and computed tomography (4%). Image-guided interventions corresponded to 8% of all radiological examinations. There were 112 injuries described, affecting muscles and tendons (42%), ligaments (25%), cartilage (21%), and bone (12%). Most injured body parts were thigh (27%), foot and ankle (23%), knee (23%), and hip/groin (8%). Most injured players were within the age range of 24-35 years old (71%).

CONCLUSION

Imaging was utilized in 11% of players who participated in the 2022 FIFA World Cup in Qatar. MRI was the most utilized modality, and acute muscle tears were the most diagnosed type of injury. Diagnostic imaging played an important role in diagnosing sports-related injuries during the 2022 FIFA World Cup.

Incidence of Sport Injuries in the Manchester 2019 World Taekwondo Championships: A Prospective Study of 936 Athletes from 145 Countries

We aimed to describe injury incidence and patterns at the 2019 World Taekwondo Championships (WTC), and to compare them with those of previous WTCs, based on new World Taekwondo (WT) competition rules, medical codes, and the Protector and Scoring System (PSS). This prospective cohort study utilized data obtained through the WT Injury Surveillance System. All athletes with injuries were evaluated by on-site sports medicine specialists, and ultrasonography was used to assess all musculoskeletal injuries. Of 936 athletes, 60 injuries were recorded (6.4 injuries/100 athletes, 95% confidence intervals [CI]: 4.8-8.0), and 4.5% (n = 42) sustained at least one injury. Males had a higher risk of sustaining injuries than females (incidence rate ratio: 1.57; 95% CI: 0.89-2.76). The most common sites, type, and mechanism were lower extremities (n = 26, 43.33%), contusion/hematoma/bruises (n = 33, 55.0%), and contact with another athlete (n = 50, 83.33%). Overall, the injury patterns associated with the mechanism of injury were similar in both the 2019 and 2017 WTCs. Refined WT competition rules and a re-established PSS at the 2019 WTC reduced the overall and severe injury incidence. Our findings can help revise Taekwondo competition rules, enhance protective equipment, optimize on-site venue medical systems, and develop injury prevention projects.

Epidemiology of MRI-detected muscle injury in athletes participating in the Tokyo 2020 Olympic Games

OBJECTIVE

Muscle injury is one of the most common injuries occurring at the Olympic Games often with devastating consequences. Epidemiological injury surveillance is recognised by the IOC as essential for injury prevention and management. We aimed to describe the incidence, anatomical location and classification of MRI-detected muscle injuries in athletes who participated in the Tokyo 2020 Olympic Games.

METHODS

Two board-certified orthopaedic surgeons, highly experienced in reviewing MRIs, independently and retrospectively reviewed all MRIs collected at the Tokyo 2020 Olympic Games from clinical reports generated by board-certified musculoskeletal radiologists at the IOC Polyclinic. The presence and anatomical site of muscle injuries were classified as: type a: myofascial/peripheral; type b: muscle belly or musculotendinous junction; and type c: injury which extends into the tendon, with reference to the British Athletics Muscle Injury Classification.

RESULTS

Fifty-nine MRI-detected muscle injuries were seen in 40 male and 19 female athletes. 24 athletes (41%) were unable to fully compete in their event. Fifty-two injuries (88%) involved lower extremity muscles with hamstring muscle injuries most common (32 of 59, 54%). Half of all muscle injuries occurred in athletes participating in athletics (30 of 59, 51%). 21 athletes (35%) sustained type a injuries, 14 athletes (24%) type b injuries and 24 athletes (41%) type c injuries. Of athletes with type c injuries, 18 (75%) did not complete their competition, a rate significantly higher than types a and b (OR 14.50, 95% CI 4.0 to 51.9, p<0.001).

CONCLUSION

For athletes sustaining muscle injuries during the Olympic Games, our study demonstrates the prognostic relevance of muscle injury anatomical site and severity for predicting completion or non-completion of an Olympic athlete's competition.

Point-of-care radiology service at the US Open Tennis Championships

Professional tennis tournaments have onsite sports medicine physicians who oversee the athletes' overall health during competition, including musculoskeletal injury and general illnesses. The medical team is composed of orthopedic and non-operative sports medicine physicians. Frequently, the tournament doctors require imaging to localize and grade musculoskeletal injuries and to make decisions regarding treatment, safe training, and return to match play. The most versatile and readily available imaging modality to evaluate for acute musculoskeletal injury is point-of-care ultrasonography. In 2015, a dedicated radiology service was created at the US Open by bringing in a musculoskeletal radiologist who would perform ultrasounds in a formal and consistent manner. In addition, the radiologist was tasked with onsite radiography as well as review of all MRI examinations done at the imaging center. This article describes how this radiology service was implemented, what types of studies were performed and the advantages of having an onsite musculoskeletal radiologist at the tournament. This service allowed the medical team to provide the comprehensive and efficient medical care required in a major professional tennis event. It also showed the value of having the in-person expertise of the musculoskeletal radiologist in the sports medicine team. This same model could be applied to other professional sporting events.

Imaging-detected bone stress injuries at the Tokyo 2020 summer Olympics: epidemiology, injury onset, and competition withdrawal rate

Background

Prevention and early detection of injuries are essential in optimising sport participation and performance. The aim of this study is to investigate the epidemiology, athlete injury history, and competition withdrawal rate of imaging-detected bone stress injuries during the Tokyo 2020 Olympic Games.

Methods

We collected and analysed imaging and clinical information in athletes with bone stress injuries diagnosed in the Olympic Village polyclinic during the Games. Two physicians independently and retrospectively reviewed all imaging examinations of bone stress injuries.

Results

A total of 11,315 individual athletes from 206 National Olympic Committees competed at the Games, during which 567 MRIs and 352 X-rays were performed at the Olympic Village polyclinic. Radiology examinations revealed four stress fractures and 38 stress reactions in 29 athletes (median age 24 years, range 18–35 years). Of these, 72% of athletes (n = 21) had symptoms before entering the Olympic Village. Bone stress injuries were most common in women (55%), the lower extremities (66%), and track and field athletes (45%). Six athletes (21%) did not start or did not finish their competitions.

Conclusions

This study revealed 42 imaging-detected bone stress injuries in the polyclinic of the Tokyo 2020 Olympic Village. The high proportion of athletes with symptoms before entering the village and the high proportion of competition withdrawals suggests the usefulness of an early MRI examination.

Association of markers of patellofemoral maltracking to cartilage damage and bone marrow lesions on MRI: Data from the 2016 Olympic Games of Rio De Janeiro

Background

Patellofemoral joint (PFJ) disease is a common ailment in elite athletes. Our aim is to report the frequency of superolateral Hoffa’s fat pad (SHFP) edema, and PFJ cartilage damage and bone marrow lesions (BML), among Olympian athletes, and to study the association between measurements of trochlear morphology and vertical patellar position and a) PFJ cartilage damage or BML, and b) SHFP edema.

Methods

All knee MRI, performed in the Olympic Village and polyclinics, of participating athletes in the 2016 Olympic Games of Rio de Janeiro were included. MRI were scored for PFJ cartilage damage and BML, and SHFP edema. Trochlear morphology measurements included sulcus angle, trochlear angle, lateral trochlear inclination, and medial trochlear inclination. Insall-Salvati ratio was also assessed.

Results

One hundred twenty-one knee MRIs were included (62 female, 51.2 %). The highest frequencies of PFJ cartilage damage, combination of PFJ cartilage damage and BML, and SHFP edema were found among Beach Volleyball and Volleyball athletes. SHFP edema was more common among female compared to male Olympian athletes. We found no statistically significant associations between different measurements of trochlear morphology/vertical patellar position, and 1. SHFP edema, and 2. PFJ cartilage damage/BML.

Conclusion

SHFP edema and the combination of PFJ cartilage damage and BML are highly frequent among Olympic athletes especially those competing in Beach volleyball and Volleyball. SHFP edema is more common among female athletes. Further studies are needed to determine whether PFJ cartilage damage has a stronger association to sports disciplines rather than trochlear morphology.

MRI-Detected Knee Ligament Sprains and Associated Internal Derangement in Athletes Competing at the Rio de Janeiro 2016 Summer Olympics

Purpose

Describe the frequency and severity of knee ligament sprains diagnosed by MRI in athletes participating at the 2016 Summer Olympic Games, their association with certain sports and assess correlations with additional knee structural injury.

Patients and Methods

All knee MRIs performed in the Olympic Village and polyclinics during the 2016 Olympics were retrospectively, blindly reviewed for ligament sprains and associated knee injuries. In addition to the absence or presence of these abnormalities, athletes were stratified by age, gender and sport.

Results

11,274 athletes participated in the 2016 Olympic Games: 113 athletes received at least one knee MRI with some having bilateral or repeat MRI on the same knee. Anterior cruciate and medial collateral ligament (ACL/MCL) sprains were most common, accounting for 32 of the 43 sprains (74.4%). Wrestling (10), hockey (7), athletics (7), and judo (5) accounted for over half of ligament sprains. ACL sprains showed a significant positive correlation with medial, lateral meniscal tears and bone contusions. The positive correlation between posterior cruciate ligament (PCL) sprains with MCL/lateral collateral ligament sprain, and popliteus tendon tear was statistically significant with 50% of total PCL sprains occurring in hockey. When athletes were stratified by gender, ligament sprains had a similar occurrence and distribution between men and women.

Conclusion

Knee ligament sprains, at the Rio 2016 Games, were most common in wrestling, hockey, athletics and judo with ACL and MCL sprains most frequent. Meniscal tears and bone contusions occurred often with ACL sprains. PCL sprains tended to be multi-ligamentous injuries. Sustained ligament sprains had similar occurrence between genders, while men had a peak incidence of sprains at a younger age and women at an older age.

Sports injuries at the Rio de Janeiro 2016 Summer Paralympic Games: use of diagnostic imaging services

OBJECTIVE

To describe the occurrence of imaging-depicted sports-related injuries (bone, muscle, tendon, and ligament injuries) during the Rio 2016 Summer Paralympic Games.

METHODS

Descriptive data on all imaging examinations by using radiography, ultrasonography (US), and MRI were collected and retrospectively analyzed centrally by five musculoskeletal radiologists according to imaging modality, country of origin of the athletes, type of sport, type of disability, and type and location of injury.

RESULTS

We report 109 injuries in 4378 athletes. A total of 382 radiologic examinations were performed in 261 athletes, including 118 (31%) radiographic, 22 (6%) US, and 242 (63%) MRI examinations. Para athletes from Africa had the highest utilization rate (20.1%, 67 out of 333). Athletes from Europe underwent the most examinations with 29 radiographic, 12 US, and 66 MRI examinations. The highest utilization rate of imaging modalities by sport was among Judo para athletes (16.7%, 22 out of 132). Most injuries were reported in athletics discipline (37.6%, 41 out of 109). Most injuries were also reported among para athletes with visual impairment (40 injuries, 36.7% of all injuries). Bone stress injuries were most common among para athletes with visual impairment (6 out of 7). Para athletes with visual impairment were also more prone to bone stress injuries than traumatic fractures, unlike para athletes with neurologic and musculoskeletal impairments.

CONCLUSIONS

Imaging was used in 6.0% of para athletes. MRI comprised 63% of imaging utilization. Identification of patterns of injuries may help building future prevention programs in elite para athletes.

KEY POINTS

• The highest imaging utilization rates were found among para athletes competing in Judo, sitting volleyball, powerlifting, and football. • Utilization of diagnostic imaging at the Rio 2016 Paralympic Games demonstrated similar trends to what was observed at the Rio 2016 Olympic Games. • Comparison of the rate of imaging-depicted injuries between Olympic and Paralympic athletes is limited due to inherent differences between the two athlete populations and the manner in which injury risk in the Paralympic athlete varies dependent on impairment type, which is not the case for the Olympic athlete.

Sports Injury and Illness after Implementation of the Web-Based Surveillance System in World Taekwondo

CONTEXT

There is a shortage of Taekwondo epidemiology studies since the rule changes introduced by World Taekwondo in 2017.

OBJECTIVE

To describe injury and illness patterns at the Muju 2017 World Taekwondo Championships (WTC) following the implementation of the web-based surveillance system by World Taekwondo.

DESIGN

Prospective cohort study.

SETTING

All injuries and illnesses were recorded during the 2017 WTC using a web-based system developed by the International Olympic Committee.

PATIENTS OR OTHER PARTICIPANTS

971 athletes who participated in the 2017 WTC.

MAIN OUTCOME MEASURE(S)

A profiles and mechanisms of injury and illness in the 2017 WTC.

RESULTS

We analyzed total 131 injuries and 26 illnesses, corresponding to an overall clinical incidence of 13.5 ((95% confidence interval (CI): 11.2-15.8)) injuries and 2.7 (95% CI: 1.6-3.7) illnesses per 100 athletes, and an overall incidence rate of 19.3 (95% CI: 16.0-22.6) injuries and 3.8 (95% CI: 2.4-5.3) illnesses per 1,000 athlete-days, respectively. Most injuries occurred in the lower extremities (46.6%, n=61), of which knee injuries were most frequent (19.8%, n=26). Among the head and trunk injuries (29.8%, n=39), face injuries (22.1%, n=29) were most frequent, whereas among upper extremity injuries (23.7%, n=31), finger injuries (6.1%, n=8) were most frequent. Contusions (33.6%, n=44) were the most frequent injury type, followed by fractures and ligament ruptures/sprains. The most common injury mechanism was in contact with another athlete (74.0%, n=97), whereas the least common was concussions (n=5). The major affected system was the respiratory system (30.8%, n=8), with major symptoms being pain (42.3%, n=11) and fever (26.9%, n=7). Environmental factors were the most common cause of illness (57.7%, n=15).

CONCLUSION

The web-based surveillance system used at the 2017 WTC revealed that 13.5/100 athletes (77.8/1,000 athlete-exposures, 13.9/1000 minute-exposures) had new or recurrent injuries, whereas 2.7/100 athletes became ill.

EFFECT OF AQUATIC EXERCISE AFTER ECCENTRIC CONTRACTION-INDUCED MUSCLE INJURY

ABSTRACT Introduction: Muscle microlesions produced by eccentric contractions (EC) cause changes in strength, endurance, power and neuromuscular activity parameters for an extended period of time. Objectives: To investigate the effect of aquatic exercise after EC-induced muscle injury on strength, endurance, power and neuromuscular activity parameters. Methods: A cross-sectional experimental study with six subjects (age 25 ± 4 years, weight 77 ± 4kg and height of 162 ± 2 cm) with EC-induced muscle injury followed up during a recovery period (48h, 72h and 96h) without intervention (Group 1A) and involving aquatic exercises (Group 1B). Dynamic and isometric strength, muscular endurance, and vertical/horizontal power tests as well as vastus lateralis neuromuscular activity measurements were performed before, immediately after, and during the recovery period. Results: Our results indicate that the intervention in Group 1B, when compared to Group 1A, accelerated the recovery of dynamic (p <0.01) and isometric (p <0.03) strength at 48h and 72h, increased vertical power at 48h (p <0.05) and horizontal power at 48h and 72h (p <0.05), and reduced neuromuscular activity (p <0.05) at 48h and 72h after EC. Conclusions: According to our findings, performing aquatic exercises during the recovery period improves muscle efficiency and accelerates strength, power and neuromuscular activity recovery. Level of evidence l; Randomized clinical trial.

Gaelic Sport Injuries

The Gaelic sports of hurling and football, native to Ireland, are increasing in popularity worldwide. The injury profile of these sports requires multidisciplinary management by sports physicians, orthopaedic surgeons, and musculoskeletal (MSK) radiologists, among others. Advances in imaging modalities and interventional techniques have aided the diagnosis and treatment of sport injuries. In this article, we review the literature and our own institutional experience to describe common injury patterns identified in Gaelic games athletes, their main imaging features and relevant therapeutic interventions. We discuss the increasing prevalence of imaging services at sporting events and the central role of MSK radiologists in sports injury management.

Knee cartilage damage and concomitant internal derangement on MRI in athletes competing at the Rio de Janeiro 2016 Summer Olympics

•

Cartilage damage is frequently observed on MRI in Olympic Athletes.

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Patellofemoral cartilage damage is most common and associated with certain sports including volleyball and weightlifting.

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Meniscal tears are associated with localized cartilage damage.

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Trend for prevalence of cartilage damage to increase with increasing age of the athlete.

Purpose

To report the MRI patterns of knee cartilage damage and concomitant internal derangement in athletes participating at the Rio de Janeiro 2016 Olympic Games.

Methods

Knee MRIs obtained at the core imaging facility of the International Olympic Committee were blindly, retrospectively reviewed by a board-certified musculoskeletal radiologist for meniscal, ligamentous, and tendon abnormalities. Cartilage assessment was based on the modified Outerbridge criteria.

Results

Of 122 athletes who received a knee MRI, 64 (52.4 %) had cartilage damage. Cartilage damage was more prevalent in the patellofemoral compartment (52 athletes, 42.6 %), followed by lateral (23 athletes, 18.9 %) and medial tibiofemoral compartments (12 athletes, 9.8 %). Patellofemoral cartilage damage was most prevalent in beach-volleyball (100 %), followed by volleyball (8 athletes, 66.7 %) and weightlifting (7 athletes, 70 %). Patellofemoral cartilage damage was most prevalent with quadriceps (8 athletes, 72.7 %) and patellar tendinosis (11 athletes, 61.1 %). Medial and lateral tibiofemoral cartilage damage was significantly associated with medial (8 athletes, 29.6 %) and lateral meniscal tears (16 athletes, 55.2 %), respectively. There was a trend for the percentage of athletes with cartilage damage to increase with age.

Conclusion

The majority of athletes at the 2016 Rio Summer Olympics who had a knee MRI showed cartilage damage. Patellofemoral compartment cartilage damage was most common and frequently observed in certain sports including volleyball, beach volleyball, and weightlifting. Overuse in these sports can contribute to patellofemoral cartilage damage and subsequent development of anterior knee pain. Cartilage damage was also observed with concomitant meniscal tears and older age.

Stress Injuries of the Spine in Sports

Spine sports stress injuries account for a significant amount of time loss at play in athletes, particularly if left unrecognized and allowed to progress. Spondylolysis makes up most of these stress injuries. This article focuses on spondylolysis, bringing together discussion from the literature on its pathomechanics and the different imaging modalities used in its diagnosis. Radiologists should be aware of the limitations and more importantly the roles of different imaging modalities in guiding and dictating the management of spondylolysis. Other stress-related injuries in the spine are also discussed including but not limited to pedicle fracture and apophyseal ring injury.

Hand-Held Portable Versus Conventional Cart-Based Ultrasound in Musculoskeletal Imaging

Background:

Portable ultrasound machines are now common, used for point-of-care applications and needle guidance for percutaneous procedures; however, the effectiveness of portable ultrasound in evaluation of the musculoskeletal system has not been fully assessed.

Purpose:

To prospectively evaluate the use of portable hand-held ultrasound in comparison with conventional cart-based ultrasound in evaluation of the musculoskeletal system.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

In this institutional review board–approved, prospective study, 100 consecutive patients with informed consent were imaged through use of both portable and cart-based ultrasound equipment using 12-5 MHz linear transducers. Agreement in ultrasound diagnosis was documented along with expected clinical changes in management if there was disagreement (definitely no, probably no, uncertain, probably yes, definitely yes). Imaging details of disagreement cases were recorded, and descriptive statistics were calculated.

Results:

There were 42 male and 58 female patients (mean ± SD age, 53 ± 13 years) imaged over a time period of 20 months. Anatomic areas scanned were the shoulder (n = 30), elbow (n = 11), hand and wrist (n = 15), hip (n = 10), knee (n = 11), foot and ankle (n = 12), and others (n = 11). Scanning with conventional ultrasound revealed abnormality in 92% of patients. Agreement in diagnosis made between portable versus cart-based ultrasound was found in 65% of patients. In the 35% of patients with discordant results, the change in diagnosis resulted in no change in clinical management in 46%, probably no change in 29%, uncertain change in 14%, probable change in 11%, and definite change in 0%. The diagnoses changing management (4%; 4/100) included nondetection of a satellite nodule (n = 1), ganglion cyst (n = 1), hernia (n = 1), and underestimated tendon tear (n = 1).

Conclusion:

When compared with conventional cart-based ultrasound, a musculoskeletal diagnosis using portable hand-held ultrasound was concordant or was discordant without clinical relevance in 96% (96/100) of patients. Knowledge of benefits and limitations of portable hand-held ultrasound will help determine areas where specific types of ultrasound equipment can be used.

MRI-detected spinal disc degenerative changes in athletes participating in the Rio de Janeiro 2016 Summer Olympics games

Objective

To describe the frequency and the distribution of degenerative disc disease (DDD) detected in athletes who underwent spine MRI in the 2016 Summer Olympic Games in Rio de Janeiro.

Methods

Data on spine MRI examinations from the 2016 Summer Olympics were retrospectively analyzed. We assessed the frequency of DDD of the cervical (Cs), thoracic (Ts), and lumbar (Ls) spine using Pfirrmann’s classification. Grade II and III were considered as mild, grade IV as moderate, and grade V as severe disc degeneration. Data were analyzed according to the location of the degenerative disc, type of sport, age-groups, and gender of the athletes.

Results

One hundred out of 11,274 athletes underwent 108 spine MRI’s (21 C, 6 T, and 81 L) (53% Females (F), 47% Males (M)). The frequency of DDD was 40% (42% F, 58% M) over the entire spine (28% mild, 9% moderate and 3% severe). There were 58% (12%F, 88%M) of the cervical spine discs that showed some degree of degeneration (44% mild, 13.5% moderate and 1% severe). Athletics, Boxing, and Swimming were the sports most affected by DDD in the Cs. There were 12.5% of the thoracic discs that showed some degree of degeneration, all were mild DDD and were exclusively seen in female athletes. There were 39% (53% F, 47% M) of the lumbar discs with DDD (26% mild, 9% moderate, and 4% severe).

Conclusion

Athletes who underwent spine MRI during the 2016 Summer Olympic Games show a high frequency of DDD of cervical and lumbar spines. Recognition of these conditions is important to develop training techniques that may minimize the development of degenerative pathology of the spine.

Prevalence of MRI-Detected Ankle Injuries in Athletes in the Rio de Janeiro 2016 Summer Olympics

OBJECTIVE

To describe the prevalence, severity, and location of ankle injuries as assessed on magnetic resonance imaging (MRI) in athletes participating in the Rio de Janeiro 2016 Summer Olympic Games.

METHODS

We analyzed all ankle MRIs that were acquired for suspected injury as reported by the National Olympic Committee medical teams and the Organizing Committee medical staff during the Rio 2016 Summer Olympics. Diagnostic imaging was performed through the Olympic Village Polyclinic. Images were interpreted retrospectively according to standardized criteria.

RESULTS

A total of 11,274 athletes participated in the Games, of which 89 (8.8%) were referred for an ankle MRI. Eighty-eight of the 89 (99%) had at least 1 abnormal finding, and some had as many as 27, for an average of 6.2 abnormalities per examination. Around one-fifth of all abnormal findings were considered pre-existing (21%) and 79% were assumed to be the result of an acute or subacute injury. The highest proportion of acute/subacute injuries per athlete occurred in ball sports (7.0 injuries per examination) and in the age group >30. Most pre-existing findings per athlete were identified in the group of others (no track and field or ball sports athletes) with 2.5 findings per examination and respectively in the age group >30 (1.7).

CONCLUSION

Our study demonstrated a high prevalence of acute and subacute, but also pre-existing injuries in Olympic athletes undergoing ankle MRI. Tendon injuries were the most common acute injuries, found mainly in ball sports athletes. Most pre-existing ankle injuries were identified at the ligaments.

Elbow Injuries Detected on Magnetic Resonance Imaging in Athletes Participating in the Rio de Janeiro 2016 Summer Olympic Games

BACKGROUND

Athletes are prone to both acute and chronic overuse injuries of the elbow joint. The purpose of this study was to describe the frequency, anatomic distribution, and severity of magnetic resonance imaging (MRI)-detected elbow joint injuries among athletes who competed in the Rio de Janeiro 2016 Summer Olympics.

METHODS

All sports injuries reported by the National Olympic Committee medical teams and the Organizing Committee medical staff during the 2016 Summer Olympics were analyzed. Magnetic resonance imaging was performed at the International Olympic Committee's polyclinic within the Olympic Village, using 3- and 1.5-T scanners. The MRIs were read centrally and retrospectively by musculoskeletal radiologists with expertise in sports injuries. The distribution of elbow joint injuries by anatomic location and sports discipline and the severity of injuries were recorded.

RESULTS

A total of 1101 injuries were reported in the 11,274 athletes from 207 teams at the Games. Central review of MRI revealed elbow joint injuries in 15 athletes (60% male; median age, 22 years; range, 18-39 years). Ligamentous injuries were most common, with injuries of the ulnar collateral ligament being the most prevalent (n = 12; 80%), followed by the common flexor tendon (n = 8; 53%). Osseous injuries were far less common (n = 3; 20%), with no acute fractures seen. Weightlifting (n = 4; 27%) and judo (n = 4; 27%) athletes were most commonly affected.

CONCLUSION

Magnetic resonance imaging-detected elbow injuries during the 2016 Summer Olympics affected mainly the ulnar collateral ligament and the common flexor tendon, with the highest occurrence in weight lifting and judo.

PyeongChang 2018 Winter Olympic Games and athletes' usage of 'polyclinic' medical services

Objective

This paper aims to describe the medical service of two polyclinics of the PyeongChang Winter Olympic Games and to analyse the injury and illness of athletes who visited the polyclinics during the oilympic period in order to provide some insight with respect to the future construction and operation of polyclinics in mass gathering events such as the Olympic Games.

Methods

The PyeongChang Olympic Village was located near the Olympic Stadium for snow sports athletes and the Gangneung Olympic Village was located near the ice venues for ice sports athletes. During the Olympic Games, polyclinics were consisted of emergency service and outpatient clinics. We retrospectively analysed the electronic medical record data of athletes who visiting polyclinics between 9 February 2018 and 25 February 2018.

Results

During the Olympics, there were 1639 athlete encounters in both polyclinics. Among those, injuries of athletes were 237 (14% of all athlete encounters) in total, and the most common injured site was knee joint. Upper respiratory infection was the most frequent case in diseases of athlete encounters. Total 223 cases of image study were done, MRI was 44 cases.

Conclusion

The PyeongChang Winter Olympic Games had the highest number of participants in the history of Winter Olympic Games. Overall 48% of athletes encountered polyclinics due to disease during the Games period. Upper respiratory infection and other seasonal diseases were more frequent this Olympic Games than before. Polyclinics were managed healthcare of athletes as well as injury and illness of athletes. In winter sports, a polyclinic and similar medical facilities should be prepare for diseases considering geography, weather as well as injuries and endemic diseases when planning future mass gathering events.

The epidemiology of MRI detected shoulder injuries in athletes participating in the Rio de Janeiro 2016 Summer Olympics

BACKGROUND

To use Magnetic Resonance Imaging (MRI) to characterize the severity, location, prevalence, and demographics of shoulder injuries in athletes at the Rio de Janeiro 2016 Summer Olympic Games.

METHODS

This was a retrospective analysis of all routine shoulder MRIs obtained from the Olympic Village Polyclinic during the Rio 2016 Summer Olympics. Imaging was performed on 1.5 T and 3 T MRI, and interpretation was centrally performed by a board-certified musculoskeletal radiologist. Images were assessed for tendon, muscle, bone, bursal, joint capsule, labral, and chondral abnormality.

RESULTS

A total of 11,274 athletes participated in the Games, of which 55 (5%) were referred for a routine shoulder MRI. Fifty-three (96%) had at least two abnormal findings. Seven (13%) had evidence of an acute or chronic anterior shoulder dislocation. Forty-nine (89%) had a rotator cuff partial tear and / or tendinosis. Subacromial / subdeltoid bursitis was present in 29 (40%). Thirty (55%) had a tear of the superior labrum anterior posterior (SLAP).

CONCLUSION

Our study demonstrated a high prevalence of both acute and chronic shoulder injuries in the Olympic athletes receiving shoulder MRI. The high rates of bursal, rotator cuff, and labral pathology found in these patients implies that some degree of glenohumeral instability and impingement is occurring, likely due to fatigue and overuse of the dynamic stabilizers. Future studies are needed to better evaluate sport-specific trends of injury.

MRI-Detected Sports-Related Knee Injuries and Abnormalities at the Rio de Janeiro 2016 Summer Olympic Games

OBJECTIVE

The purpose of this article is to describe knee abnormalities and the occurrence of MRI-detected sports-related knee abnormalities by evaluating MRI examinations performed during the Rio de Janeiro Olympic Games held in August 2016.

CONCLUSION

There were 11,274 athletes at the Rio 2016 Olympic Games, and 113 of them underwent at least one knee MRI in the Olympic Village. Cartilage abnormalities, followed by meniscal tears and ligament sprains, were the most frequent abnormalities.

The epidemiology of MRI-detected pelvic injuries in athletes in the Rio de Janeiro 2016 Summer Olympics

OBJECTIVE

To describe the prevalence, severity and location of pelvic injuries, including hip, muscle and tendon pathologies, as assessed on MRI in athletes participating in the Rio de Janeiro 2016 Summer Olympic Games.

METHODS

We analyzed all pelvic MRIs that were acquired for suspected injury as reported by the National Olympic Committee (NOC) medical teams and the Organizing Committee medical staff during the Rio 2016 Summer Olympics. Diagnostic imaging was performed through the Olympic Village Polyclinic, using 3 T and 1.5 T MR scanners. Images were interpreted retrospectively according to standardized criteria.

RESULTS

A total of 11,274 athletes participated in the Games, of which 40 (0,4%) were referred for a pelvic MRI. Thirty-seven of the 40 (92%) had at least one abnormal finding, and some had as many as 17, for an average of 4.1 pathologies per examination. Almost half of all abnormal findings were assessed as pre-existing (46%). The majority of acute/subacute injuries were observed in track and field athletes (44%), whereas the highest number of pre-existing findings was seen in ball-sports athletes (39%). Forty-seven per cent of all acute/subacute injuries were muscle injuries with the gluteus maximus muscle the most commonly affected. In contrast, most pre-existing findings were detected at the symphysis (59%).

CONCLUSION

Our study demonstrated a high prevalence of both acute/subacute injuries and chronic changes in Olympic athletes undergoing pelvic MRI. Muscle injuries were the most common acute injuries, found mainly in track and field athletes. Most chronic changes were identified at the symphysis region in ball-sports athletes.