L26: Role of Imaging in Major Sporting Events

Question 1

Why has there been a dramatic increase in the use of imaging in management of sports injuries in the last 20 years?

Answer 1

partly due to diversity of sporting options, and extension of participation of younger and older athletes

• from 1996-2005, there was an increase in MSK MRI exams of 354% and MSK US exams of 200%
• at Winter Olympics, number of imaging exams has tripled from SLC (394) to PyeongChang (14030)

Question 2

What is the British Athletics Muscle Injury System?

Answer 2

muscle injury grading system based on the MRI features of the muscle injury

• grades 0-4
• grades a/b/c (myofascial/MTJ/intratendinous) for grades 1-4 based on site and extent of injury
• hemorrhage?
• validated
• RTP for ‘c’ injuries longer, and have higher recurrence rate
• mean +/- SD for RTFT: 3c classification
• re-injury rates (%) for BAMI groups highest in intratendinous (c)

Question 3

What are some examples of BAMI grades?

Answer 3

• BAMI 1a: peripheral 10%, < 5 cm, no fibre disruption
• BAMI 2b: 10-50% area, 5-15 cm length, central tendon intact
• BAMI 3b: central, > 50%, > 15 cm length, central tendon intact
• BAMI 3c: central tendon wavy
• BAMI 4: full thickness tear

Question 4

What is a good first-line modality for sports injuries that are in the soft tissues?

Answer 4

ultrasound

Question 5

What is a good modality for sports injuries if a fracture is suspected?

Answer 5

x-ray and CT

Question 6

Why is it important to differentiate between muscular vs. musculotendinous injuries?

Answer 6

when it involves the central tendon in particular, this has poorer outcomes

Question 7

How does a streamlined radiology department at the site of sporting events helpful?

Answer 7

• efficient diagnosis (x-ray, CT, ultrasound, or MRI) – need to be quick, need the right test
• management – require surgery vs. rest/immobilization