Course

Radiology

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11 Lessons

Radiology plays an important role in the investigation of many sports medicine injuries. The most widely ordered studies include X-rays and ultrasound scans. X-rays are the simplest modality for defining bony injuries, while ultrasound enables assessment of many soft-tissue structures including muscles, tendons and ligaments. In general terms, these investigations are complementary and an ultrasound scan should not be ordered in isolation. There are a range of other modalities which can be useful. These include CT, MRI and scintigraphy (and other nuclear-medicine scans). The single most widely used high-tech imaging modality is MRI. This provides good quality bone and soft tissue detail.

This module will review each of the individual imaging modalities commonly used in sports medicine and discuss the strengths and limitations of each. It will also outline some of the potential problems associated with these investigations.

Presented by

Learning outcomes

By the end of this module, you should:

  • understand the different imaging modalities that are available to assess musculoskeletal injuries and other sports medicine conditions;
  • understand the indications for X-rays and ultrasound scans for many common sports medicine injuries;
  • understand the indications and role of MRI for the assessment of musculoskeletal injuries;
  • understand the indications for other imaging modalities including CT scans and scintigrams;
  • have an awareness of some of the limitations of imaging studies and the possible adverse outcomes associated with their use.

Tasks

  • Review the media content and read the provided text
  • Read the suggested articles
  • Complete the case-based assessment task

Required reading

The impact of imaging in sports medicine in sports medicine

John Read

Aspetar Sports Medicine Journal, Vol 1, Issue 1, April 2012

Suggested reading

Brukner and Khan’s Clinical Sports Medicine 4th Edition

Chapter 12 (pages 157-163)

References

  1. Jones JG, Mills CN, Mogensen MA, Lee CI. Radiation dose from medical imaging: A primer for emergency physicians. West J Emerg Med. 2012;13(2):202-210.
  2. Jenkin M, Sitler MR, Kelly JD. Clinical usefulness of the ottawa ankle rules for detecting fractures of the ankle and midfoot. J Athl Train. 2010;45(5):480-482.
  3. Bruner P, Khan K. Brukner & khan’s clinical sports medicine. 4th Ed ed. Sydney: McGraw-Hill Australia; 2012.
  4. Verral G. Clincal and imaging diagnosis and grading of hamstring injuries. Aspetar Sports Medicine Journal. 2013;2:15 November 2016.
  5. Reurink G, Goudswaard GJ, Tol JL, et al. MRI observations at return to play of clinically recovered hamstring injuries. Br J Sports Med. 2014;48(18):1370-1376.
  6. Dvorak J, George J, Junge A, Hodler J. Application of MRI of the wrist for age determination in international U-17 soccer competitions. Br J Sports Med. 2007;41(8):497-500.
  7. Dvorak J, George J, Junge A, Hodler J. Age determination by magnetic resonance imaging of the wrist in adolescent male football players. Br J Sports Med. 2007;41(1):45-52.
  8. Tscholl PM, Junge A, Dvorak J, Zubler V. MRI of the wrist is not recommended for age determination in female football players of U-16/U-17 competitions. Scandinavian journal of medicine & science in sports JID – 9111504. 0226.
  9. Wittschieber D, Vieth V, Timme M, Dvorak J, Schmeling A. Magnetic resonance imaging of the iliac crest: Age estimation in under-20 soccer players. Forensic Sci Med Pathol. 2014;10(2):198-202.