Russell Jeffrey A, Yoshioka Hiroshi
School of Applied Health Sciences, Ohio University, Athens, Ohio, USA
Department of Radiological Sciences, School of Medicine, University of California, Irvine, California, USA.
Acta Radiol. 2016 Aug;57(8):978-84. doi: 10.1177/0284185115616295. Epub 2015 Nov 13.
The en pointe position of the ankle in ballet is extreme. Previously, magnetic resonance imaging (MRI) of ballet dancers' ankles en pointe was confined to a low field, open MR device.
To develop a reproducible ankle MRI protocol for ballet dancers en pointe and to assess the positions of the key structures in the dancers ankles.
Six female ballet dancers participated; each was randomly assigned to stand en pointe while one of her feet and ankles was splinted with wooden rods affixed with straps or to begin with the ankle in neutral position. She lay in an MR scanner with the ankle inside a knee coil for en pointe imaging and inside an ankle/foot coil for neutral position imaging. Proton density weighted images with and without fat suppression and 3D water excitation gradient recalled echo images were obtained en pointe and in neutral position in sagittal, axial, and coronal planes. We compared the bones, cartilage, and soft tissues within and between positions.
No difficulties using the protocol were encountered. En pointe the posterior articular surface of the tibial plafond was incongruent with the talar dome and rested on the posterior talus. The posterior edge of the plafond impinged Kager's fat pad. All participants exhibited one or more small ganglion cysts about the ankle and proximal foot, as well as fluid accumulation in the flexor and fibularis tendon sheaths.
Our MRI protocol allows assessment of female ballet dancers' ankles in the extreme plantar flexion position in which the dancers perform. We consistently noted incongruence of the talocrural joint and convergence of the tibia, talus, and calcaneus posteriorly. This protocol may be useful for clinicians who evaluate dancers.
芭蕾舞中脚踝的足尖姿势非常极端。此前，对处于足尖姿势的芭蕾舞演员脚踝进行磁共振成像（MRI）仅限于低场开放式MR设备。
制定一种可重复的针对处于足尖姿势的芭蕾舞演员的脚踝MRI方案，并评估舞者脚踝关键结构的位置。
六名女性芭蕾舞演员参与；每位演员被随机分配为单脚站立在足尖姿势，其一只脚和脚踝用附有绑带的木棒固定，或者从脚踝处于中立位置开始。她躺在MR扫描仪中，足尖姿势成像时脚踝置于膝关节线圈内，中立位置成像时置于脚踝/足部线圈内。在矢状面、轴面和冠状面分别获取有和没有脂肪抑制的质子密度加权图像以及3D水激发梯度回波图像，分别在足尖姿势和中立位置进行成像。我们比较了不同姿势下以及姿势之间的骨骼、软骨和软组织情况。
使用该方案未遇到困难。在足尖姿势时，胫距关节面后缘与距骨穹窿不匹配，位于距骨后方。关节面后缘压迫了Kager脂肪垫。所有参与者在脚踝和足部近端均表现出一个或多个小腱鞘囊肿，以及屈肌和腓骨肌腱鞘内有积液。
我们的MRI方案能够对女性芭蕾舞演员在表演时的极度跖屈姿势下的脚踝进行评估。我们始终注意到距小腿关节不匹配以及胫骨、距骨和跟骨在后方汇聚。该方案可能对评估舞者的临床医生有用。
