MRI Aids Analysis of Perplexing Football Injuries

professional football draft and found 57 tears of the lateral meniscus, a flat, disc-shaped ligament that supports the outer knee joint, and 26 tears of the medial meniscus, which supports the inner knee joint.

"These findings are remarkable because the authors of most previous studies have reported a predominance of medial meniscal injuries,” remarked Jeffrey Towers, M.D., lead author of the study and associate professor of radiology at the University of Pittsburgh Medical Center (PA, US).

At first, Dr. Towers assumed that the unusually high percentage of lateral meniscal tears was associated with anterior cruciate ligament (ACL) tears. ACL tears are somewhat typical among elite college football players, and 80% of meniscal tears that occur in association with ACL tears are in the outer knee joint.

The study revealed that whereas 18 lateral and eight medial meniscal tears were found in conjunction with ACL tears, 36 lateral and 18 medial tears were isolated injuries. The findings also included evidence of three earlier lateral tears. "What we found is that almost three-quarters of the lateral meniscal tears were not in the setting of ACL tears,” Dr. Towers said.

Dr. Towers thinks that the findings of this high incidence of lateral meniscal tears among elite athletes may have a considerable impact on improving clinicians' ability to detect and treat this injury. In a second article, Dr. Towers and coworkers identified for the first time an indirect sign of syndesmotic tear, a frequently misdiagnosed injury more commonly known as high ankle sprain. At present, the injury is most typically diagnosed by an uncomfortable physical examination of the syndesmosis, a large ligament above the ankle.

The investigators utilized MRI and x-rays to study 18 candidates for the 2005 professional football draft who were discovered to have a history of high ankle sprain. Fourteen x-rays demonstrated an abnormal growth of new bone, known as periostosis, at the lower part of the tibia. Two MRI scans revealed abnormal swelling caused by fluid at the same site.




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