about monitoring stress injury of the talar dome with dynamic MRI and CBCT exam
Today I present you the clinical picture of a medial talar bone edema and spongious impaction of an elite runner; I’d like to remind you that a bone bruise is a subchondral osseous fracture of the cancellous microarchitecture with accompanied local hemorrhage and edema, so less indication for ultrasound imaging in this case. Yes, with ultrasound we can perfectly see the cortical irregularity but nothing about the definitive staging of the disease, so don’t forget: MRI is the method of choice (Stress Fracture in Runners).
Three months after the study was completed with Cone-Beam Ct scan; try to identify risk factors and training errors predisposing to stress fractures is mandatory.
I always use the dynamic MRI-CBCT examination before the return to activity.
Remember not to misdiagnose the normal irregular ossification of the femoral condyles as stage I osteochondral defect, especially when using ultrasound; MR imaging is helpful in distinguishing this normal variant.
Dynamic ultrasound scan of the anterior aspect of the lateral femoral condyle of a young football player.
Sagittal Ge-Stir and T1 weighted Mri of the same patient (0.3 Tesla). The overlying articular cartilage is intact.