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Flores DV, Murray TÉ, Bohyn C, Mohr B, Cresswell M. Imaging Review of Alpine Ski Injuries. Semin Musculoskelet Radiol 2022; 26:41-53. [PMID: 35139558 DOI: 10.1055/s-0041-1731794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Skiing is a continuously evolving winter sport, responsible for a considerable number of musculoskeletal injuries. Specific injury patterns and mechanisms in the upper and lower extremities, head, and spine are influenced by skier expertise and skill, position during injury, and environmental conditions. Predilection for certain joints and injury patterns have changed over time, largely due to technological advancements in equipment, increased awareness campaigns, and preventive protocols. Knowledge and understanding of these trends and developments can aid the radiologist to reach a timely and accurate diagnosis, thereby guiding clinical management and potentially reducing the overall incidence of debilitation and death.
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Affiliation(s)
- Dyan V Flores
- Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Timothy É Murray
- Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Cedric Bohyn
- Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Radiology, AZ Monica, Antwerpen, Belgium
| | - Bruce Mohr
- Whistler Health Care Center, Whistler, British Columbia, Canada
| | - Mark Cresswell
- Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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Meredith TJ, Falk NP, Rennicke J, Hornsby H. Athletic Injuries. Fam Med 2022. [DOI: 10.1007/978-3-030-54441-6_59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Meredith TJ, Falk NP, Rennicke J, Hornsby H. Athletic Injuries. Fam Med 2020. [DOI: 10.1007/978-1-4939-0779-3_59-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jibri Z, Jamieson P, Rakhra KS, Sampaio ML, Dervin G. Patellar maltracking: an update on the diagnosis and treatment strategies. Insights Imaging 2019; 10:65. [PMID: 31201575 PMCID: PMC6570735 DOI: 10.1186/s13244-019-0755-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 05/21/2019] [Indexed: 02/08/2023] Open
Abstract
Patellar maltracking occurs as a result of an imbalance in the dynamic relationship between the patella and trochlea. This is often secondary to an underlying structural abnormality. The clinical evaluation can provide useful clues for the presence of such entity; however, the diagnosis can often be challenging especially in the absence of a documented history of patellar dislocation. Imaging, particularly MRI, can detect subtle features that could lead to the diagnosis, probably even more importantly when there is no clear history of patellar dislocation or before its development. This can provide a road map for formulating a treatment strategy that would be primarily aimed at stabilizing the patellofemoral joint to halt or slow the progression of articular cartilage loss. The purpose of this article is to discuss the clinical and radiologic evaluation of patellar maltracking providing an update on the cross-sectional imaging assessment and also a synopsis of the management options.
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Affiliation(s)
- Zaid Jibri
- Department of Medical Imaging, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada. .,Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
| | - Paul Jamieson
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.,Division of Orthopaedic Surgery, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
| | - Kawan S Rakhra
- Department of Medical Imaging, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.,Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada
| | - Marcos L Sampaio
- Department of Medical Imaging, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.,Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada
| | - Geoffrey Dervin
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.,Division of Orthopaedic Surgery, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
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Flores DV, Mejía Gómez C, Pathria MN. Layered Approach to the Anterior Knee: Normal Anatomy and Disorders Associated with Anterior Knee Pain. Radiographics 2018; 38:2069-2101. [DOI: 10.1148/rg.2018180048] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Dyan V. Flores
- From the Department of Radiology, Philippine Orthopedic Center, Institute of Radiology, St Luke’s Medical Center Global City, Maria Clara Street, Santa Mesa Heights, Quezon City, Metro Manila, Philippines 1100 (D.V.F.); Department of Radiology, Hospital Pablo Tobón Uribe, Medellín, Colombia (C.M.G.); and Department of Radiology, UCSD Medical Center, San Diego, Calif (M.N.P.)
| | - Catalina Mejía Gómez
- From the Department of Radiology, Philippine Orthopedic Center, Institute of Radiology, St Luke’s Medical Center Global City, Maria Clara Street, Santa Mesa Heights, Quezon City, Metro Manila, Philippines 1100 (D.V.F.); Department of Radiology, Hospital Pablo Tobón Uribe, Medellín, Colombia (C.M.G.); and Department of Radiology, UCSD Medical Center, San Diego, Calif (M.N.P.)
| | - Mini N. Pathria
- From the Department of Radiology, Philippine Orthopedic Center, Institute of Radiology, St Luke’s Medical Center Global City, Maria Clara Street, Santa Mesa Heights, Quezon City, Metro Manila, Philippines 1100 (D.V.F.); Department of Radiology, Hospital Pablo Tobón Uribe, Medellín, Colombia (C.M.G.); and Department of Radiology, UCSD Medical Center, San Diego, Calif (M.N.P.)
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Abstract
The treatment of patellar instability is challenging and typically begins with nonoperative methods. Clinical decisions are made on an individual basis and may vary according to a number of factors. First-time patellar dislocations most commonly occur during sports participation. Initial evaluation, including patient history, physical examination, and appropriate imaging, determines care. Although nonoperative treatment consists primarily of regressive immobilization and physical therapy, there is little evidence to support particular protocols for either. Factors that may contraindicate nonoperative treatment include osteochondral lesions and recurrent instability. In these cases, surgery is considered. Reported recurrence rates after nonoperative treatment of acute patellar dislocation are 15% to 44%. Well-designed studies are needed to determine not only the outcomes of nonoperative versus surgical treatment of patellar instability but also the risk factors that may predict poor outcomes in either group.
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