High-resolution axial MR imaging of tibial stress injuries

• Main Authors: Mammoto Takeo, Hirano Atsushi, Tomaru Yohei, Kono Mamoru, Tsukagoshi Yuta, Onishi Sinzo, Mamizuka Naotaka
• Format: Article
• Language: English
• Published: BMC 2012-05-01
• Series: Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology
• Subjects: Tibial stress injury; High resolution MR imaging; Stress fracture; Shin splint
• Online Access: http://www.smarttjournal.com/content/4/1/16

<p>Abstract</p> <p>Purpose</p> <p>To evaluate the relative involvement of tibial stress injuries using high-resolution axial MR imaging and the correlation with MR and radiographic images.</p> <p>Methods</p> <p>A total of 33 patients with exercise-induced tibial pain were evaluated. All patients underwent radiograph and high-resolution axial MR imaging. Radiographs were taken at initial presentation and 4 weeks later. High-resolution MR axial images were obtained using a microscopy surface coil with 60 × 60 mm field of view on a 1.5T MR unit. All images were evaluated for abnormal signals of the periosteum, cortex and bone marrow.</p> <p>Results</p> <p>Nineteen patients showed no periosteal reaction at initial and follow-up radiographs. MR imaging showed abnormal signals in the periosteal tissue and partially abnormal signals in the bone marrow. In 7 patients, periosteal reaction was not seen at initial radiograph, but was detected at follow-up radiograph. MR imaging showed abnormal signals in the periosteal tissue and entire bone marrow. Abnormal signals in the cortex were found in 6 patients. The remaining 7 showed periosteal reactions at initial radiograph. MR imaging showed abnormal signals in the periosteal tissue in 6 patients. Abnormal signals were seen in the partial and entire bone marrow in 4 and 3 patients, respectively.</p> <p>Conclusions</p> <p>Bone marrow abnormalities in high-resolution axial MR imaging were related to periosteal reactions at follow-up radiograph. Bone marrow abnormalities might predict later periosteal reactions, suggesting shin splints or stress fractures. High-resolution axial MR imaging is useful in early discrimination of tibial stress injuries.</p>