Bone stress injury of the ankle in professional ballet dancers seen on MRI

Ilan Elias, Adam C. Zoga, Steven M. Raikin, Judith R. Peterson, Marcus Peter Besser, William B. Morrison, Mark E. Schweitzer

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background. Ballet Dancers have been shown to have a relatively high incidence of stress fractures of the foot and ankle. It was our objective to examine MR imaging patterns of bone marrow edema (BME) in the ankles of high performance professional ballet dancers, to evaluate clinical relevance. Methods. MR Imaging was performed on 12 ankles of 11 active professional ballet dancers (6 female, 5 male; mean age 24 years, range 19 to 32). Individuals were imaged on a 0.2 T or 1.5 T MRI units. Images were evaluated by two musculoskeletal radiologists and one orthopaedic surgeon in consensus for location and pattern of bone marrow edema. In order to control for recognized sources of bone marrow edema, images were also reviewed for presence of osseous, ligamentous, tendinous and cartilage injuries. Statistical analysis was performed to assess the strength of the correlation between bone marrow edema and ankle pain. Results. Bone marrow edema was seen only in the talus, and was a common finding, observed in nine of the twelve ankles imaged (75%) and was associated with pain in all cases. On fluid-sensitive sequences, bone marrow edema was ill-defined and centered in the talar neck or body, although in three cases it extended to the talar dome. No apparent gender predilection was noted. No occult stress fracture could be diagnosed. A moderately strong correlation (phi = 0.77, p= 0.0054) was found between edema and pain in the study population. Conclusion. Bone marrow edema seems to be a specific MRI finding in the talus of professional ballet dancers, likely related to biomechanical stress reactions, due to their frequently performed unique maneuvers. Clinically, this condition may indicate a sign of a bone stress injury of the ankle.

Original languageEnglish (US)
Article number39
JournalBMC Musculoskeletal Disorders
Volume9
DOIs
StatePublished - Apr 29 2008

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Ankle Injuries
Edema
Bone Marrow
Bone and Bones
Ankle
Talus
Stress Fractures
Pain
Closed Fractures
Cartilage
Foot
Consensus
Neck
Incidence
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Rheumatology
  • Orthopedics and Sports Medicine

Cite this

Elias, I., Zoga, A. C., Raikin, S. M., Peterson, J. R., Besser, M. P., Morrison, W. B., & Schweitzer, M. E. (2008). Bone stress injury of the ankle in professional ballet dancers seen on MRI. BMC Musculoskeletal Disorders, 9, [39]. https://doi.org/10.1186/1471-2474-9-39
Elias, Ilan ; Zoga, Adam C. ; Raikin, Steven M. ; Peterson, Judith R. ; Besser, Marcus Peter ; Morrison, William B. ; Schweitzer, Mark E. / Bone stress injury of the ankle in professional ballet dancers seen on MRI. In: BMC Musculoskeletal Disorders. 2008 ; Vol. 9.
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Bone stress injury of the ankle in professional ballet dancers seen on MRI. / Elias, Ilan; Zoga, Adam C.; Raikin, Steven M.; Peterson, Judith R.; Besser, Marcus Peter; Morrison, William B.; Schweitzer, Mark E.

In: BMC Musculoskeletal Disorders, Vol. 9, 39, 29.04.2008.

Research output: Contribution to journalArticle

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AU - Elias, Ilan

AU - Zoga, Adam C.

AU - Raikin, Steven M.

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AU - Morrison, William B.

AU - Schweitzer, Mark E.

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N2 - Background. Ballet Dancers have been shown to have a relatively high incidence of stress fractures of the foot and ankle. It was our objective to examine MR imaging patterns of bone marrow edema (BME) in the ankles of high performance professional ballet dancers, to evaluate clinical relevance. Methods. MR Imaging was performed on 12 ankles of 11 active professional ballet dancers (6 female, 5 male; mean age 24 years, range 19 to 32). Individuals were imaged on a 0.2 T or 1.5 T MRI units. Images were evaluated by two musculoskeletal radiologists and one orthopaedic surgeon in consensus for location and pattern of bone marrow edema. In order to control for recognized sources of bone marrow edema, images were also reviewed for presence of osseous, ligamentous, tendinous and cartilage injuries. Statistical analysis was performed to assess the strength of the correlation between bone marrow edema and ankle pain. Results. Bone marrow edema was seen only in the talus, and was a common finding, observed in nine of the twelve ankles imaged (75%) and was associated with pain in all cases. On fluid-sensitive sequences, bone marrow edema was ill-defined and centered in the talar neck or body, although in three cases it extended to the talar dome. No apparent gender predilection was noted. No occult stress fracture could be diagnosed. A moderately strong correlation (phi = 0.77, p= 0.0054) was found between edema and pain in the study population. Conclusion. Bone marrow edema seems to be a specific MRI finding in the talus of professional ballet dancers, likely related to biomechanical stress reactions, due to their frequently performed unique maneuvers. Clinically, this condition may indicate a sign of a bone stress injury of the ankle.

AB - Background. Ballet Dancers have been shown to have a relatively high incidence of stress fractures of the foot and ankle. It was our objective to examine MR imaging patterns of bone marrow edema (BME) in the ankles of high performance professional ballet dancers, to evaluate clinical relevance. Methods. MR Imaging was performed on 12 ankles of 11 active professional ballet dancers (6 female, 5 male; mean age 24 years, range 19 to 32). Individuals were imaged on a 0.2 T or 1.5 T MRI units. Images were evaluated by two musculoskeletal radiologists and one orthopaedic surgeon in consensus for location and pattern of bone marrow edema. In order to control for recognized sources of bone marrow edema, images were also reviewed for presence of osseous, ligamentous, tendinous and cartilage injuries. Statistical analysis was performed to assess the strength of the correlation between bone marrow edema and ankle pain. Results. Bone marrow edema was seen only in the talus, and was a common finding, observed in nine of the twelve ankles imaged (75%) and was associated with pain in all cases. On fluid-sensitive sequences, bone marrow edema was ill-defined and centered in the talar neck or body, although in three cases it extended to the talar dome. No apparent gender predilection was noted. No occult stress fracture could be diagnosed. A moderately strong correlation (phi = 0.77, p= 0.0054) was found between edema and pain in the study population. Conclusion. Bone marrow edema seems to be a specific MRI finding in the talus of professional ballet dancers, likely related to biomechanical stress reactions, due to their frequently performed unique maneuvers. Clinically, this condition may indicate a sign of a bone stress injury of the ankle.

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