Table Of ContentMedical Radiology · Diagnostic Imaging
Series Editors: Hans-Ulrich Kauczor · Paul M. Parizel · Wilfred C. G. Peh
Filip M. Vanhoenacker
Mario Maas
Jan L. M. A. Gielen Editors
Imaging
of Orthopedic
Sports Injuries
Second Edition
Medical Radiology
Diagnostic Imaging
Series Editors
Hans-Ulrich Kauczor
Paul M. Parizel
Wilfred C. G. Peh
The book series Medical Radiology – Diagnostic Imaging provides accurate
and up-to-date overviews about the latest advances in the rapidly evolving
field of diagnostic imaging and interventional radiology. Each volume is
conceived as a practical and clinically useful reference book and is developed
under the direction of an experienced editor, who is a world-renowned
specialist in the field. Book chapters are written by expert authors in the field
and are richly illustrated with high quality figures, tables and graphs. Editors
and authors are committed to provide detailed and coherent information in a
readily accessible and easy-to-understand format, directly applicable to daily
practice.
Medical Radiology – Diagnostic Imaging covers all organ systems and
addresses all modern imaging techniques and image-guided treatment
modalities, as well as hot topics in management, workflow, and quality and
safety issues in radiology and imaging. The judicious choice of relevant topics,
the careful selection of expert editors and authors, and the emphasis on
providing practically useful information, contribute to the wide appeal and
ongoing success of the series. The series is indexed in Scopus.
For further volumes: http://www.springer.com/series/4354
Filip M. Vanhoenacker • Mario Maas
Jan L. M. A. Gielen
Editors
Imaging of Orthopedic
Sports Injuries
Second Edition
Editors
Filip M. Vanhoenacker Jan L. M. A. Gielen
Department of Radiology Department of Radiology
Antwerp University Hospital Antwerp University Hospital
Edegem, Belgium Edegem, Belgium
Mario Maas
Department of Radiology and Nuclear
Medicine
Amsterdam University Medical Centres
Amsterdam, The Netherlands
ISSN 0942-5373 ISSN 2197-4187 (electronic)
Medical Radiology
ISBN 978-3-030-75361-0 ISBN 978-3-030-75362-7 (eBook)
https://doi.org/10.1007/978-3-030-75362-7
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Foreword to the Second Edition
Soon after we assumed Editorships of the Medical Radiology Series of
Springer Nature, one of the first books that was targeted for an updated edi-
tion was Imaging of Orthopedic Sports Injuries, edited by Professors Filip
Vanhoenacker, Mario Maas and Jan Gielen. When approached, lead editor
Professor Vanhoenacker readily agreed to take on this task and after a period
of planning, commenced on the project which took about 1 year to complete.
This is a very efficient turnaround time by any standard, let alone for a monu-
mental project such as this.
Following on the outstanding success of the original book published in
2007, Professors Vanhoenacker, Maas and Gielen have once again put
together this truly excellent second edition. The new book has not only
expanded in terms of additional chapters but also contains much new content
that reflects the continued growth and updated knowledge of imaging and
imaging-guided intervention of sports injuries. The authorship list of this
book can be regarded a “Who’s who” of musculoskeletal radiologists in
Europe, with the exception of one chapter authored from Singapore and
Australia!
It gives both of us great personal pleasure to be able to congratulate Filip
for successfully overseeing the second edition of this book. Wilfred has
known Filip for about 20 years, having been involved together as faculty in
many annual congresses in Europe and North America organised by the
European Society of Skeletal Radiology (ESSR) and the International
Skeletal Society (ISS). Being fellow musculoskeletal radiologists with a
strong sense of academic obligation, both have also contributed substantially
to congresses and teaching programmes held in Asia under the auspices of the
Asian Musculoskeletal Society, an organisation in which Wilfred served as
the Founding President, as well as the ISS regional outreach programmes and
meetings of other regional and national radiological societies in Asia. Wilfred
and Filip have, more importantly, become firm friends over these many years.
Paul and Filip go back even further, having known each other since the
beginning of their professional careers as radiologists in Belgium. Their pro-
fessional collaboration has expanded far beyond the local and national level,
onto the international and European arena. Throughout the years, both have
collaborated on many projects, courses and meetings organised by the
European Society of Radiology (ESR), the ESSR and the European Society
of Neuroradiology (ESNR). Through serendipity, it so happened that in the
year 2017, Filip was President of the ESSR while Paul was President of the
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vi Foreword to the Second Edition
ESR, and this happy coincidence further enhanced their collaboration on
many projects. Importantly, their collaboration on scientific projects has
grown into a long-lasting friendship spanning several decades and built on a
foundation of respect and mutual understanding.
Over the recent two decades or so, imaging has become increasingly
important in the diagnosis, management, therapy guidance, and follow-up of
patients with sports injuries. Healthcare professionals, and in particular
orthopaedic surgeons, are increasingly reliant on imaging data to make clini-
cal decisions. New developments in imaging technology have greatly
advanced our insights into the pathophysiology of sports injuries. This prog-
ress has created not only new opportunities for radiologists and nuclear medi-
cine physicians but also new challenges. We must learn to understand and
speak the language of our clinical colleagues, and we need to acquire clinical
background knowledge about mechanisms of injury and repair and about
their pathophysiology. Together with orthopaedic surgeons, specialists in
physical medicine and rehabilitation, physical therapists and many other
healthcare professionals, radiologists and nuclear medicine physicians are an
essential part of the multidisciplinary team that makes evidence-based deci-
sions in patients with sports injuries. This book provides a comprehensive
overview of the subject and shall prove to be equally useful to both imaging
professionals and referring clinicians.
The second edition of Imaging of Orthopedic Sports Injuries is therefore
very timely. We have no doubt that this book will be most successful and
sought after as a “must-read” by everyone with an interest in and wishing to
learn more about imaging of musculoskeletal sports injuries.
July 2020 Wilfred C. G. Peh
Department of Diagnostic Radiology
Khoo Teck Puat Hospital
Singapore, Singapore
Yong Loo Lin School of Medicine
National University of Singapore
Singapore, Singapore
Paul M. Parizel
Royal Perth Hospital &
University of Western Australia
Perth, Australia
Preface to the Second Edition
Today more than ever, sports activities are no longer the privilege of competi-
tive and professional athletes or the “select happy few”, but almost all sports
disciplines are accessible to a large population in all age groups.
The sporting population is vulnerable to musculoskeletal lesions due to
either acute trauma or overuse. It was already underscored in the first edition
of this book that imaging of these patients plays an important role in diagno-
sis, grading, defining appropriate treatment regime, and follow-up.
Since the first edition in 2007, imaging techniques have been further
refined, indications have expanded, and new insights in pathogenesis and
imaging of musculoskeletal sports trauma evolved tremendously.
Therefore, we are very grateful that the series editors of Medical Radiology
(Springer) professor Wilfred Peh and professor Paul Parizel entrusted us with
the task to update our work.
Ultrasound is generally accepted as the “working horse” for the evaluation
of trauma of the ligaments, tendons and muscles, particularly for dynamic
evaluation of these structures. The overall availability of MRI has increased,
and the technique is now a mature and indispensable diagnostic tool for the
evaluation of internal joint derangement in every sports clinic.
Although CT is generally replaced by MRI, (Cone Beam) CT may be very
useful for the diagnosis of occult fractures of (small) bones and is particularly
important in the evaluation of maxillofacial sports trauma, where it com-
pletely replaced plain radiography.
Compared to the previous edition, the general structure of this book has
been maintained, with a general part on basic sciences and general imaging
principles, followed by an extensive topographic discussion of musculoskel-
etal sports injuries and lastly some special addenda.
The text of the book has been largely updated, and many new state-of-the-
art images were added. We included new chapters on imaging-guided inter-
vention of sports injuries and postoperative joint imaging in the sportive
patient.
Furthermore, we dedicated one chapter to imaging of soccer injuries, as
one of the most popular sports worldwide.
We are very grateful to all contributing authors, being internationally
renowned experts in musculoskeletal imaging, for their willingness to deliver
outstanding contributions.
vii
viii Preface to the Second Edition
Finally—on behalf of my co-editors—I would like to express our special
thanks to Springer for giving us the opportunity to edit the second edition of
this book.
We hope that this work will be helpful in the daily practice of general and
musculoskeletal radiologists and everyone else involved in sports medicine
and we hope you enjoy reading it.
Antwerp, Belgium Filip M. Vanhoenacker
July 2020
Introduction
Endorsement on Behalf of the European Society
of Musculoskeletal Radiology (ESSR)
Musculoskeletal (MSK) injuries occurring from sports play today an impor-
tant role in the diagnosis and treatment of MSK disorders. Recent advances
in imaging have greatly aided the diagnosis and treatment decision-making in
patients with sports injuries. Imaging can be used to make diagnoses, define
prognoses, influence treatment plans, or to preoperatively assess the severity
of known pathology, and follow-up recovery of the injury. Let us simplify:
imaging of sports injuries is challenging, interesting, and evolving. The use
of imaging and its various modalities depends on the clinical information and
availability of those modalities. The goal of musculoskeletal imaging is to
provide as much information as possible to allow timely and appropriate
patient care. The musculoskeletal radiologist plays a pivotal role and has a
strong tool in hands to start managing sports injuries. A strong tool primarily
assumes knowledge: Knowledge about body anatomy, pathophysiology,
mechanism of injury, injuries pattern, advances and limitation of different
imaging modalities as well as typical injuries for any specific sport. The aim
of the European Society of Musculoskeletal Radiology and its Sports
Subcommittee is to encourage the advancement of knowledge. Therefore, the
publication of this book, Imaging of Orthopedic Sports Injuries, is an impor-
tant highlight for the radiological profession and for all those involved in
sports injuries management.
All parts of the book offer an invaluable wealth of fundamental insights
and new achievements in sports injuries imaging.
The first part of the book contains information on relevant basic science
and general imaging principles in sports traumatology. The second part com-
prises a topographic discussion of sports injuries and elaborates the merit of
different imaging techniques and different clinical problems focused on a
specific location. In the third part, monitoring and follow-up of sports injuries
and their repair by imaging are discussed. The fourth part leads through
imaging-guided intervention procedures and postoperative imaging of sports
injuries.
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