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1.
Curr Sports Med Rep ; 20(1): 57-61, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33395131

RESUMEN

ABSTRACT: Sports ultrasound (US) is a rapidly advancing and expanding field, where "hands-on" education and real-time instructor feedback are paramount in developing this skill. In light of a global pandemic and limited access to instructors and educational conferences, sports US education must adapt to continue to teach future ultrasonographers. Virtual US education, conducted using various virtual meeting platforms not only allows for continued didactic education but also can virtually recreate the "hands-on" training sessions with live, immediate instructor feedback that is necessary for acquiring competence. Additionally, using these methods, sports US conferences can continue in a virtual manner, sports US education can expand remote areas, and collaboration among distant experts may increase, all without the cost of travel and extended time away from work. While immediately relevant because of the COVID-19 pandemic, virtual US methods may continue to be beneficial as sports US education and collaboration continue to expand.


Asunto(s)
Traumatismos en Atletas/diagnóstico por imagen , Colaboración Intersectorial , Ultrasonografía/tendencias , Realidad Virtual , Predicción , Humanos
2.
Orthopade ; 50(2): 163-171, 2021 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-33512561

RESUMEN

The number of adolescents and children in elite and high-intensity mass sports is increasing, with respect to industrial nations. High-intensity training can cause overload due to the increased traction effect, particularly on tendon and muscle insertion sites. Apophyses are the center for ossification in tendon and muscle insertions and are therefore particularly vulnerable in youths to overload-related pathologies. Core measures in the prevention are a systematic planning of training and the avoidance of mechanical overstraining in the growth period. An exact imaging enables the diagnosis of apophyseal structural damage at an early stage, which in this phase can be healed by a pause in training and conservative measures.


Asunto(s)
Traumatismos en Atletas , Deportes , Adolescente , Traumatismos en Atletas/diagnóstico por imagen , Traumatismos en Atletas/terapia , Huesos , Niño , Humanos , Osteogénesis , Tendones
4.
Clin Sports Med ; 40(1): 111-121, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33187602

RESUMEN

Mild traumatic brain injuries, or concussions, often result in transient brain abnormalities not readily detected by conventional imaging methods. Several advanced imaging studies have been evaluated in the past couple decades to improve understanding of microstructural and functional abnormalities in the brain in patients suffering concussions. The thought remains a functional or pathophysiologic change rather than a structural one. The mechanism of injury, whether direct, indirect, or rotational, may drive specific clinical and radiological presentations. This remains a dynamic and constantly evolving area of research. This article focuses on the current status of imaging and future directions in concussion-related research.


Asunto(s)
Traumatismos en Atletas/diagnóstico por imagen , Conmoción Encefálica/diagnóstico por imagen , Neuroimagen/métodos , Traumatismos en Atletas/fisiopatología , Encéfalo/diagnóstico por imagen , Encéfalo/fisiopatología , Conmoción Encefálica/fisiopatología , Humanos
5.
Clin Sports Med ; 40(1): 187-197, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33187608

RESUMEN

The recommendation to retire from sport after concussion has evolved with the understanding of concussion. Age, sport, position, level of play, relevant medical and concussion history, severity and duration of symptoms, neuroimaging and neuropsychological testing should all be considered. Susceptibility to injury, persistence of symptoms, psychological distress, and personal values and support may also play a role. Pediatric athletes may require a more conservative approach, given ongoing growth and development. For professional and/or elite athletes, financial or career implications may be considerations. When possible, retirement should be a shared decision among the athlete, the family, and the health care team.


Asunto(s)
Traumatismos en Atletas/diagnóstico , Traumatismos en Atletas/psicología , Conmoción Encefálica/diagnóstico , Conmoción Encefálica/psicología , Toma de Decisiones Conjunta , Jubilación , Traumatismos en Atletas/diagnóstico por imagen , Traumatismos en Atletas/terapia , Conmoción Encefálica/diagnóstico por imagen , Conmoción Encefálica/terapia , Familia , Humanos , Neuroimagen , Pruebas Neuropsicológicas , Grupo de Atención al Paciente , Volver al Deporte
6.
Clin Sports Med ; 40(1): 199-211, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33187610

RESUMEN

This article focuses on 3 concepts that continue to be investigated in the search for the holy grail of concussion-a valid diagnostic test. Imaging advances are discussed with optimism that functional MRI and diffusion tensor imaging may be available clinically. Biomarkers and the use of genetic tests are covered. Sideline accelerometer use may help steer discussions of head trauma risk once technology exists to accurately estimate acceleration of the brain. In the meantime, strategies including allowing athletes to be substituted out of games for an evaluation and video review in elite sports can improve recognition of sports-related concussion.


Asunto(s)
Traumatismos en Atletas/diagnóstico , Conmoción Encefálica/diagnóstico , Medicina Deportiva/tendencias , Acelerometría , Traumatismos en Atletas/diagnóstico por imagen , Traumatismos en Atletas/terapia , Biomarcadores , Conmoción Encefálica/diagnóstico por imagen , Conmoción Encefálica/terapia , Imagen de Difusión Tensora , Pruebas Genéticas , Humanos , Imagen por Resonancia Magnética
7.
Clin Sports Med ; 40(1): 39-51, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33187612

RESUMEN

After a concussion, a series of complex, overlapping, and disruptive events occur within the brain, leading to symptoms and behavioral dysfunction. These events include ionic shifts, damaged neuronal architecture, higher concentrations of inflammatory chemicals, increased excitatory neurotransmitter release, and cerebral blood flow disruptions, leading to a neuronal crisis. This review summarizes the translational aspects of the pathophysiologic cascade of postconcussion events, focusing on the role of excitatory neurotransmitters and ionic fluxes, and their role in neuronal disruption. We review the relationship between physiologic disruption and behavioral alterations, and proposed treatments aimed to restore the balance of disrupted processes.


Asunto(s)
Traumatismos en Atletas/fisiopatología , Conmoción Encefálica/fisiopatología , Traumatismos en Atletas/diagnóstico por imagen , Conmoción Encefálica/diagnóstico por imagen , Humanos , Neuroimagen
8.
Medicine (Baltimore) ; 99(41): e22609, 2020 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-33031317

RESUMEN

The aim of the study was to evaluate the outcomes of arthroscopic repair using the all-inside inter-leaf vertical suture arthroscopic technique for sports-related horizontal meniscal tears.The inter-leaf vertical suture procedure was performed to repair sports-related horizontal tears in the middle and posterior segments of the medial (11 cases) and lateral (2 cases) menisci in 13 patients (mean age: 30 ±â€Š14 years). Pre- and post-operative Barrett criteria, Lysholm scores, and patient ability to resume sports were assessed. Magnetic resonance imaging (MRI) grades and signal intensity changes near the joint capsule were evaluated in the 9 cases among which pre- and post-operative MRI images were available.All Barrett criteria items were negative following surgery; Lysholm scores increased from 70.2 ±â€Š13.1 before surgery to 98.9 ±â€Š2.64 after surgery (P < .01). All patients were able to resume their sport. Preoperative MRI grade of tears was 3 for all patients; postoperative MRI grades were 1 in 3 cases, 2 in 4 cases, and 3 in 2 cases (P < .05). Importantly, MRI signal intensity at the repaired menisci near the joint capsule was reduced in 8 of these 9 cases postoperatively.The inter-leaf vertical suture procedure is associated with good outcomes for horizontal tears in the middle and posterior segments of the medial and lateral menisci. The procedure is useful and convenient.


Asunto(s)
Artroscopía/métodos , Traumatismos en Atletas/cirugía , Lesiones de Menisco Tibial/cirugía , Adolescente , Adulto , Artroscopía/estadística & datos numéricos , Traumatismos en Atletas/diagnóstico por imagen , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Lesiones de Menisco Tibial/diagnóstico por imagen , Resultado del Tratamiento , Adulto Joven
10.
Bone Joint J ; 102-B(10): 1281-1288, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32993323

RESUMEN

Injuries to the hamstring muscle complex are common in athletes, accounting for between 12% and 26% of all injuries sustained during sporting activities. Acute hamstring injuries often occur during sports that involve repetitive kicking or high-speed sprinting, such as American football, soccer, rugby, and athletics. They are also common in watersports, including waterskiing and surfing. Hamstring injuries can be career-threatening in elite athletes and are associated with an estimated risk of recurrence in between 14% and 63% of patients. The variability in prognosis and treatment of the different injury patterns highlights the importance of prompt diagnosis with magnetic resonance imaging (MRI) in order to classify injuries accurately and plan the appropriate management. Low-grade hamstring injuries may be treated with nonoperative measures including pain relief, eccentric lengthening exercises, and a graduated return to sport-specific activities. Nonoperative management is associated with highly variable times for convalescence and return to a pre-injury level of sporting function. Nonoperative management of high-grade hamstring injuries is associated with poor return to baseline function, residual muscle weakness and a high-risk of recurrence. Proximal hamstring avulsion injuries, high-grade musculotendinous tears, and chronic injuries with persistent weakness or functional compromise require surgical repair to enable return to a pre-injury level of sporting function and minimize the risk of recurrent injury. This article reviews the optimal diagnostic imaging methods and common classification systems used to guide the treatment of hamstring injuries. In addition, the indications and outcomes for both nonoperative and operative treatment are analyzed to provide an evidence-based management framework for these patients. Cite this article: Bone Joint J 2020;102-B(10):1281-1288.


Asunto(s)
Traumatismos en Atletas/terapia , Músculos Isquiosurales/lesiones , Traumatismos de la Pierna/terapia , Traumatismos de los Tejidos Blandos/terapia , Traumatismos en Atletas/diagnóstico por imagen , Músculos Isquiosurales/diagnóstico por imagen , Humanos , Traumatismos de la Pierna/diagnóstico por imagen , Imagen por Resonancia Magnética , Manejo del Dolor , Pronóstico , Traumatismos de los Tejidos Blandos/diagnóstico por imagen
11.
Orthop Clin North Am ; 51(4): 461-469, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32950215

RESUMEN

Participation in skiing and snowboarding continues to increase. Both sports are associated with unique equipment and movement patterns, placing athletes at risk for several characteristic injuries. Although the axial skeleton and extremities are at risk for injury in both sports, skiing and snowboarding are associated with distinctive injury patterns. This article summarizes the epidemiology, risk factors, and specific injuries associated with skiing and snowboarding to better educate orthopedic surgeons regarding diagnosis and treatment of athletes partaking in these sports.


Asunto(s)
Traumatismos en Atletas/epidemiología , Esquí/lesiones , Traumatismos en Atletas/diagnóstico por imagen , Traumatismos en Atletas/etiología , Humanos
12.
PLoS One ; 15(8): e0235609, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32776940

RESUMEN

Soccer is the most popular sport in the world and, since it is a contact sport, players are at risk for head injury, including concussion. Here, we proposed to investigate the association of heading and concussion with macroscopic brain structure among adult amateur soccer players. For this study, 375 amateur soccer players (median age 23 years) completed HeadCount-12m to estimate heading over the 12 months prior to MRI and lifetime concussion. T1-weighted 3D magnetization prepared rapid acquisition gradient echo (MP-RAGE) MRI was performed at 3 Tesla. Parcellation was performed using Freesurfer to extract regional gray and white matter volumes as well as regional cortical thickness and total intracranial volume. Regional cortical brain volumes were normalized by total intracranial volume. We categorized heading into quartiles and concussion as 0, 1 or 2 or more. Generalized linear regressions were used to test the association of heading or concussion with each brain morphometry metric, including age and sex, as covariates. Neither heading nor concussion were associated with reduced brain volume or cortical thickness. We observed that greater heading was associated with greater gray matter volume in the left inferior parietal area, which may reflect effects related to training.


Asunto(s)
Traumatismos en Atletas/diagnóstico por imagen , Conmoción Encefálica/diagnóstico por imagen , Encéfalo/diagnóstico por imagen , Corteza Cerebral/diagnóstico por imagen , Fútbol , Adulto , Encéfalo/anatomía & histología , Conmoción Encefálica/etiología , Corteza Cerebral/anatomía & histología , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Tamaño de los Órganos
13.
Neurology ; 95(7): e781-e792, 2020 08 18.
Artículo en Inglés | MEDLINE | ID: mdl-32641518

RESUMEN

OBJECTIVE: To study longitudinal recovery trajectories of white matter after sports-related concussion (SRC) by performing diffusion tensor imaging (DTI) on collegiate athletes who sustained SRC. METHODS: Collegiate athletes (n = 219, 82 concussed athletes, 68 contact-sport controls, and 69 non-contact-sport controls) were included from the Concussion Assessment, Research and Education Consortium. The participants completed clinical assessments and DTI at 4 time points: 24 to 48 hours after injury, asymptomatic state, 7 days after return-to-play, and 6 months after injury. Tract-based spatial statistics was used to investigate group differences in DTI metrics and to identify white-matter areas with persistent abnormalities. Generalized linear mixed models were used to study longitudinal changes and associations between outcome measures and DTI metrics. Cox proportional hazards model was used to study effects of white-matter abnormalities on recovery time. RESULTS: In the white matter of concussed athletes, DTI-derived mean diffusivity was significantly higher than in the controls at 24 to 48 hours after injury and beyond the point when the concussed athletes became asymptomatic. While the extent of affected white matter decreased over time, part of the corpus callosum had persistent group differences across all the time points. Furthermore, greater elevation of mean diffusivity at acute concussion was associated with worse clinical outcome measures (i.e., Brief Symptom Inventory scores and symptom severity scores) and prolonged recovery time. No significant differences in DTI metrics were observed between the contact-sport and non-contact-sport controls. CONCLUSIONS: Changes in white matter were evident after SRC at 6 months after injury but were not observed in contact-sport exposure. Furthermore, the persistent white-matter abnormalities were associated with clinical outcomes and delayed recovery time.


Asunto(s)
Traumatismos en Atletas/rehabilitación , Conmoción Encefálica/patología , Imagen de Difusión Tensora , Sustancia Blanca/patología , Adolescente , Adulto , Atletas , Traumatismos en Atletas/diagnóstico por imagen , Conmoción Encefálica/diagnóstico , Conmoción Encefálica/fisiopatología , Cuerpo Calloso/patología , Cuerpo Calloso/fisiopatología , Imagen de Difusión por Resonancia Magnética/métodos , Imagen de Difusión Tensora/métodos , Femenino , Fútbol Americano/lesiones , Humanos , Masculino , Sustancia Blanca/fisiopatología , Adulto Joven
14.
PLoS One ; 15(6): e0234401, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32584826

RESUMEN

Previous studies suggest that marathon running induces lower extremity muscle damage. This study aimed to examine inter- and intramuscular differences in hamstring muscle damage after a marathon using transverse relaxation time (T2)-weighted magnetic resonance images (MRI). 20 healthy collegiate marathon runners (15 males) were recruited for this study. T2-MRI was performed before (PRE) and at 1 (D1), 3 (D3), and 8 days (D8) after marathon, and the T2 values of each hamstring muscle at the distal, middle, and proximal sites were calculated. Results indicated that no significant intermuscular differences in T2 changes were observed and that, regardless of muscle, the T2 values of the distal and middle sites increased significantly at D1 and D3 and recovered at D8, although those values of the proximal site remained constant. T2 significantly increased at distal and middle sites of the biceps femoris long head on D1 (p = 0.030 and p = 0.004, respectively) and D3 (p = 0.007 and p = 0.041, respectively), distal biceps femoris short head on D1 (p = 0.036), distal semitendinosus on D1 (p = 0.047) and D3 (p = 0.010), middle semitendinosus on D1 (p = 0.005), and distal and middle sites of the semimembranosus on D1 (p = 0.008 and p = 0.040, respectively) and D3 (p = 0.002 and p = 0.018, respectively). These results suggest that the distal and middle sites of the hamstring muscles are more susceptible to damage induced by running a full marathon. Conditioning that focuses on the distal and middle sites of the hamstring muscles may be more useful in improving recovery strategies after prolonged running.


Asunto(s)
Traumatismos en Atletas/diagnóstico por imagen , Traumatismos en Atletas/etiología , Músculos Isquiosurales/diagnóstico por imagen , Músculos Isquiosurales/lesiones , Carrera/fisiología , Traumatismos en Atletas/fisiopatología , Rendimiento Atlético/fisiología , Femenino , Músculos Isquiosurales/patología , Humanos , Contracción Isométrica/fisiología , Japón , Imagen por Resonancia Magnética , Masculino , Factores de Tiempo , Torque , Adulto Joven
15.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 64(3): 160-166, mayo-jun. 2020. ilus, tab
Artículo en Español | IBECS | ID: ibc-196336

RESUMEN

OBJETIVO: Cuantificar la desviación angular de la articulación interfalángica distal (IFD) del 5.° dedo y la presencia de cambios degenerativos en IFD en jugadores de pelota y compararlos con una población española. MATERIAL Y MÉTODOS: Estudio de casos y controles de una población de 40 pelotaris manomanistas federados y de un grupo control formado por 20 varones no practicantes de pelota. Se calcularon el ángulo IFD y la presencia de cambios degenerativos en la articulación. RESULTADOS: El ángulo IFD medio del 5.° dedo en el grupo control fue de 2,6° en la mano dominante y de 2,9° en mano no dominante. Grupo de pelotaris: ángulo IFD de 6,8° en mano dominante y 10,9° en la no dominante. El ángulo IFD fue significativamente mayor en la mano no dominante (p = 0,002) en el grupo de pelotaris. No se encontraron diferencias significativas entre ambas manos en el grupo control (p = 0,572). Se hallaron diferencias estadísticamente significativas tanto para la mano dominante (p = 0,001) como para la no dominante (p = 0,001) al comparar grupo control con pelotaris. Los pelotaris tienen un ángulo IFD superior a los controles en ambas manos. No se encontraron diferencias estadísticamente significativas en grupo pelotari según la posición en la cancha (p = 0,742 delantero, p = 0,747 zaguero) ni por categorías (p = 0,345 aficionado, p = 0,346 profesional). DISCUSIÓN: La práctica de pelota a mano se asocia a la presencia de una clinodactilia postraumática de la falange distal del 5.° dedo. La mano no dominante presenta unos ángulos mayores en IFD. La presencia de clinodactilia no genera limitación funcional


OBJECTIVE: The aim of this study is to measure the DIP joint angle of the little finger and presence of degenerative changes in the DIP joint in Basque hand-pelota players and compare it with the general Spanish population. MATERIAL AND METHODS: Cross-sectional study. We studied both hands of 40 male Basque pelota players (pelotaris) and 20 male controls. The assessment protocol consisted of a questionnaire, physical examination and bilateral plain radiographs. Distal interphalangeal (DIP) joint angle was measured on plain radiographs in both hands. RESULTS: The average DIP joint angle of the little finger in the control group was 2.6° in the dominant hand and 2.9° in the other hand. In the pelota players group we obtained a DIP angle of 6.8° in the dominant hand and 10.9° in the non-dominant hand. The DIP angle was significantly higher in the non-dominant hand (P=.002) in the pelota player group. Non-significant differences were obtained between both hands in the control group (p=.572). Significant differences were obtained in both player and control groups in the dominant hand (P=.001) and in the non-dominant hand (P=.001). Pelota players have a higher DIP angle in the little fingers than the control group. No differences were found in the pelota player group according to their position on the court (P=.742 forward, P=.747 defender) or sport level (P=.345 amateur, P=.346 professional). DISCUSSION: Basque hand-pelota produces post-traumatic acquired clinodactyly of the little finger. The non-dominant hand has a higher DIP joint angle. Clinodactyly poses no functional problems


Asunto(s)
Humanos , Masculino , Adolescente , Adulto Joven , Adulto , Traumatismos en Atletas/fisiopatología , Traumatismos de los Dedos/fisiopatología , Rango del Movimiento Articular/fisiología , Traumatismos en Atletas/diagnóstico por imagen , Traumatismos de los Dedos/diagnóstico por imagen , Estudios de Casos y Controles , Muñeca/fisiopatología
16.
Clin Sports Med ; 39(3): 503-522, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32446571

RESUMEN

The overhead throwing motion subjects the elbow to a predictable pattern of forces, including medial tension, lateral compression, and posterior shear, that in turn result in a predictable pattern of injuries. Careful history taking, thorough physical examination, and judicious diagnostic imaging allow clinicians to correctly diagnose ulnar collateral ligament (UCL) injury. Athletes with UCL injury complain of acute or chronic medial elbow injury, resulting in decreased throwing effectiveness, with loss of control and/or velocity. Magnetic resonance imaging is the gold standard for diagnosis, but stress ultrasound rapidly is becoming an important adjunct, particularly in diagnostically challenging situations.


Asunto(s)
Traumatismos en Atletas/diagnóstico , Ligamento Colateral Cubital/lesiones , Traumatismos en Atletas/diagnóstico por imagen , Béisbol/lesiones , Ligamento Colateral Cubital/fisiología , Articulación del Codo/anatomía & histología , Articulación del Codo/diagnóstico por imagen , Articulación del Codo/fisiología , Humanos , Imagen por Resonancia Magnética , Examen Físico , Ultrasonografía
17.
Clin Sports Med ; 39(3): 523-536, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32446572

RESUMEN

Ulnar collateral ligament (UCL) injuries can significantly impair the overhead athlete. Reconstruction of the anterior bundle of the UCL (UCL-R) has allowed a high proportion of these individuals to return to their previous level of play. Several techniques for UCL-R are described that produce acceptable results with an overall low complication rate. Transient ulnar neuritis is the most common complication following UCL-R. The rate of UCL injury in young athletes is rising with increased youth involvement and year-round participation in overhead sports. The sports medicine community must broaden its focus to not only treat UCL injuries but also prevent them.


Asunto(s)
Traumatismos en Atletas/cirugía , Ligamento Colateral Cubital/lesiones , Reconstrucción del Ligamento Colateral Cubital , Adolescente , Traumatismos en Atletas/diagnóstico , Traumatismos en Atletas/diagnóstico por imagen , Béisbol/lesiones , Ligamento Colateral Cubital/cirugía , Humanos , Examen Físico , Complicaciones Posoperatorias , Volver al Deporte , Factores de Riesgo , Reconstrucción del Ligamento Colateral Cubital/efectos adversos , Reconstrucción del Ligamento Colateral Cubital/métodos , Deportes Juveniles/lesiones
18.
Clin Sports Med ; 39(3): 673-685, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32446583

RESUMEN

Distal triceps ruptures are uncommon, usually caused by a fall on an outstretched hand or a direct blow. Factors linked to injury include eccentric loading of a contracting triceps, anabolic steroid use, weightlifting, and traumatic laceration. Risk factors include local steroid injection, hyperparathyroidism, and olecranon bursitis. Initial diagnosis can be complicated by pain and swelling, and a palpable defect is not always present. Plain radiographs can be helpful. MRI confirms the diagnosis and directs treatment. Incomplete tears can be treated nonsurgically; complete tears are best managed surgically. Good to excellent restoration of function has been shown with surgical repair.


Asunto(s)
Traumatismos en Atletas/diagnóstico por imagen , Traumatismos en Atletas/terapia , Rotura/diagnóstico por imagen , Rotura/terapia , Traumatismos de los Tendones/diagnóstico por imagen , Traumatismos de los Tendones/terapia , Traumatismos en Atletas/etiología , Traumatismos en Atletas/cirugía , Humanos , Imagen por Resonancia Magnética , Músculo Esquelético/lesiones , Radiografía , Factores de Riesgo , Rotura/etiología , Rotura/cirugía , Traumatismos de los Tendones/etiología , Traumatismos de los Tendones/cirugía
19.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 39(2): 112-134, mar.-abr. 2020. ilus, tab
Artículo en Español | IBECS | ID: ibc-196358

RESUMEN

El aumento de la participación en la práctica de deporte y actividad física promovido ampliamente por el enfoque hacia un estilo de vida físicamente activo, con efecto positivo para un envejecimiento saludable, tanto en pacientes como en atletas de todas las edades, principiantes y expertos, en el deportista aficionado y en el profesional, ha causado una mayor incidencia de las lesiones relacionadas con el deporte. El diagnóstico precoz y preciso de la lesión que permita iniciar precozmente el tratamiento adecuado para conseguir la recuperación completa es fundamental en el contexto deportivo, y las técnicas de imagen son cada vez más importantes para el éxito diagnóstico y el manejo del paciente. Las técnicas de medicina nuclear con trazadores óseos proporcionan información fisiológica y metabólica en las fases precoces de la lesión osteoarticular, precediendo a menudo a los cambios anatómicos, y reflejan los cambios en el recambio óseo, permitiendo el diagnóstico precoz y la valoración de la actividad y de la fase evolutiva de la lesión. En el presente artículo se describen las aplicaciones de la medicina nuclear, en particular de la gammagrafía ósea, con el valor aportado por los estudios híbridos (SPECT/TC) en el diagnóstico y la evaluación de las distintas lesiones deportivas osteoarticulares y de tejidos blandos, su utilidad en la expresión de la fisiopatología de estas lesiones y su apariencia gammagráfica. Asimismo se explican aspectos biomecánicos y fisiopatológicos, los mecanismos lesionales y las presentaciones clínicas de las lesiones deportivas musculoesqueléticas, cuyo conocimiento es esencial para la correcta valoración diagnóstica de las imágenes


Increased participation in sports and physical exercise are widely promoted as an approach to a physically active lifestyle which has a positive effect on healthy aging, in patients and athletes of all ages, beginners and experts, including amateur athletes and professional athletes. Unfortunately, this has caused a higher incidence of sports-related injuries. In the sports context, the early and accurate diagnosis of injuries is of the utmost importance in order to enable early treatment to achieve a full recovery. Imaging techniques are increasingly important for the successful diagnosis and management of the patient. The nuclear medicine techniques with bone tracers provide physiological and metabolic information in the early phases of musculoskeletal injuries, which often precede anatomical changes and they reflect changes in bone turnover. This allows early diagnosis, along with evaluation of the activity and phase of the injury. In this article, the applications of nuclear medicine techniques, focusing on bone scintigraphy, alongside the important contribution of hybrid studies (SPECT/CT), in the diagnosis of bone and soft tissue sports injuries, will be described. In addition, we explain their usefulness in the expression of the pathophysiology of these lesions and their scintigraphic patterns. The article will also describe biomechanical and physiopathological aspects, injury mechanisms and clinical presentations of bone and joint sports injuries, knowledge of this is essential for the correct diagnostic assessment of imaging studies


Asunto(s)
Humanos , Traumatismos en Atletas/diagnóstico por imagen , Entesopatía/diagnóstico por imagen , Fracturas Óseas/diagnóstico por imagen , Artritis/diagnóstico por imagen , Artritis/etiología , Fenómenos Biomecánicos , Diagnóstico por Imagen/métodos , Diagnóstico Precoz , Curación de Fractura , Fracturas por Estrés/diagnóstico por imagen , Fracturas no Consolidadas/complicaciones , Fracturas no Consolidadas/diagnóstico por imagen , Tomografía de Emisión de Positrones , Tomografía Computarizada por Rayos X , Radiofármacos , Distrofia Simpática Refleja/diagnóstico por imagen , Distrofia Simpática Refleja/etiología , Tomografía Computarizada de Emisión de Fotón Único , Espondilólisis/diagnóstico por imagen
20.
Clin Sports Med ; 39(2): 223-245, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32115082

RESUMEN

Imaging plays a key role in the evaluation and treatment planning of hand and wrist injuries in athletes. Depending on the suspected injury, a combination of conventional radiographs, computed tomography, magnetic resonance imaging, magnetic resonance arthrography, and/or ultrasound may be indicated. This article reviews the strengths and limitations of these imaging modalities and how they can be utilized in commonly encountered clinical questions.


Asunto(s)
Traumatismos en Atletas/diagnóstico por imagen , Traumatismos de la Mano/diagnóstico por imagen , Traumatismos de la Muñeca/diagnóstico por imagen , Artrografía , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Tomografía Computarizada por Rayos X , Ultrasonografía
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