gms | German Medical Science

7th EFSMA – European Congress of Sports Medicine, 3rd Central European Congress of Physical Medicine and Rehabilitation, Annual Assembly of the German and the Austrian Society of Physical Medicine and Rehabilitation

Austrian Society of Physical Medicine and Rehabilitation

26.-29.10.2011, Salzburg, Österreich

MRI evaluation in young patients with clinical suspition of medial tibial stress syndrome (MTSS)

Meeting Abstract

  • corresponding author Antonia Bintoudi - Department of Radiology, Papageorgiou Genaral Hospital, Thessaloniki, Germany
  • author Despoina Konstantinou - Department of Radiology, Papageorgiou Genaral Hospital, Thessaloniki, Germany
  • author Vera Kyriakou - Department of Radiology, Papageorgiou Genaral Hospital, Thessaloniki, Germany
  • author Charalampos Maskalidis - Department of Radiology, Papageorgiou Genaral Hospital, Thessaloniki, Germany
  • author Natasa Kotziamani - Department of Radiology, Papageorgiou Genaral Hospital, Thessaloniki, Germany
  • author presenting/speaker Christos Lyrtzis - Department of Anatomy. Aristotle University of Thessaloniki, Thessaloniki, Germany
  • author Konstantinos Natsis - Department of Anatomy. Aristotle University of Thessaloniki, Thessaloniki, Germany

7th EFSMA – European Congress of Sports Medicine, 3rd Central European Congress of Physical Medicine and Rehabilitation. Salzburg, 26.-29.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11esm225

DOI: 10.3205/11esm225, URN: urn:nbn:de:0183-11esm2250

Veröffentlicht: 24. Oktober 2011

© 2011 Bintoudi et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Medial tibial stress syndrome (MTSS) is one of the most common leg injuries in athletes and soldiers. It was proposed an MR rating system for the MTSS. There are four different stages: a) Periosteal edema (grade I), b) moderate to sever periosteal edema with marrow edema (grade II), c)marrow edema (grade III) and d) fracture line (grade IV) .The purpose of this paper is to correlate the imaging findings, stage of MTSS, duration and type of treatment and the follow up after conservative treatment.

Material/Methods: Four young athletes aged between 16–23 years old (mean age 18,6 years) were transmitted to our department with clinical leg pain. All patients underwent initial radiography. One patient underwent also CT examination with a Picker PQ 5000 CT scan. In all patients were performed also MRI examination at 1 Tesla Siemens Expert Plus. They were obtained conventional T1 WI before and after intravenous administration of contrast agent, T2 WI and STIR in axial and coronal levels. At both MRI examinations, before and after treatments were evaluated location of the stress injuries, types of bone alterations, presence or absence of periosteal and bone marrow edema. Results were correlated with duration of conservative treatment.

Results: Two of the patients were soldiers and two young athletes. Only in one case the radiography was positive due to the presence of one osteolytic lesion which was initially misdiagnosed as osteoid osteoma and was falsely treated with radiofrequency (RF) ablation. It was the same patient that underwent CT scan for the detection of the lesion and the treatment. Two patients were classified as grade I , localized periosteal edema, medial tibial stress syndrome, one as grade II , moderate to sever periosteal edema and localized marrow edema, medial tibial stress syndrome and one grade III, sever marrow edema. In our study there was no patient with fracture line, grade IV. All the patients were treated conservative. In one case after treatment MRI was negative. At the rest of the cases there was a significant improvement of the findings.

Conclusion: MRI and sometimes CT evaluation in patients with clinical suspicion of medial tibial stress syndrome is the gold standard method not only for the diagnosis but mostly for the follow up .This is due to the fact that treatment to MTSS is, at most of the cases, conservative and not always effective. That is why MRI examination is essential.


References

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