Isolated adductor longus avulsion in a young semi-professional football player: Imaging contribution and therapeutic considerations.

Adductor longus injuries are usually observed at the proximal musculo-tendinous junction, but isolated tendinous ruptures (i.e., avulsion) at the origin on the pubic bone are uncommon. In this article, we report a new case of isolated adductor longus avulsion that occurred in a young athlete and was treated with conservative therapy. An 18 years old semi-professional football player, in the attempt to reach the ball with his right leg, reported acute pain and functional limitation in his left adductor area. Clinical examination showed tenderness on palpation associated with mild swelling. Manual strength testing of adductor muscles showed weakness and elicited moderate pain in the proximal groin region near the pubic bone. The diagnostic evaluations (ultrasound [3-14 MHz linear probe] and magnetic resonance imaging [1.5 Tesla magnetic field]), performed a few days after the event, showed a complete isolated avulsion of the proximal adductor longus tendon associated with a fluid collection, with a gap of about 9.5 mm from its insertion on the pubic bone. Degenerative alterations (sub-chondral sclerosis, bone edema, erosions, cortical irregularities, calcifications) were found. These findings were crucial in the treatment choice because conservative management is suggested when the gap is below 1 cm and when no important displacement of proximal torn tendon's end at dynamic ultrasound is appreciated. A structured rehabilitation protocol was implemented, allowing the player to come back to his full athletic activity after 146 days. Return to play was allowed when several subjective and objective parameters were fully satisfied (full hip range of motion, pain-free football-specific activities, less than a 5%-10% difference in hip adduction strength between the injured and uninjured legs, advanced anatomical healing of the adductor longus tendon seen on diagnostic exams, and Hip And Groin Outcome Score [HAGOS] scores similar to baseline data). This case report emphasizes the importance of diagnostic imaging and clinical assessments in the management of an adductor longus avulsion with short retraction (about 1 cm). Both imaging techniques are non-invasive and without risks, allow contra-lateral examination and may guide in the treatment choice; moreover, they significantly influence the post-care approach by enabling to fine-tune a safe return to full athletic activity with minor re-injury rate. While US can be used as primary imaging modality, MRI offers a higher level of accuracy.

A2Bn-1PbnI3n+1 (A = BA, PEA; B = MA; n = 1, 2): Engineering Quantum-Well Crystals for High Mass Density and Fast Scintillators.

Quantum-well (QW) hybrid organic-inorganic perovskite (HOIP) crystals, e.g., A2PbX4 (A = BA, PEA; X = Br, I), demonstrated significant potentials as scintillating materials for wide energy radiation detection compared to their individual three-dimensional (3D) counterparts, e.g., BPbX3 (B = MA). Inserting 3D into QW structures resulted in new structures, namely A2BPb2X7 perovskite crystals, and they may have promising optical and scintillation properties toward higher mass density and fast timing scintillators. In this article, we investigate the crystal structure as well as optical and scintillation properties of iodide-based QW HOIP crystals, A2PbI4 and A2MAPb2I7. A2PbI4 crystals exhibit green and red emission with the fastest PL decay time <1 ns, while A2MAPb2I7 crystals exhibit a high mass density of >3.0 g/cm3 and tunable smaller bandgaps <2.1 eV resulting from quantum and dielectric confinement. We observe that A2PbI4 and PEA2MAPb2I7 show emission under X- and γ-ray excitations. We further observe that some QW HOIP iodide scintillators exhibit shorter radiation absorption lengths (∼3 cm at 511 keV) and faster scintillation decay time components (∼0.5 ns) compared to those of QW HOIP bromide scintillators. Finally, we investigate the light yields of iodide-based QW HOIP crystals at 10 K (∼10 photons/keV), while at room temperature they still show pulse height spectra with light yields between 1 and 2 photons/keV, which is still >5 times lower than those for bromides. The lower light yields can be the drawbacks of iodide-based QW HOIP scintillators, but the promising high mass density and decay time results of our study can provide the right pathway for further improvements toward fast-timing applications.