Nussbaum A R, Treves S T, Micheli L
Department of Radiology, Children's Hospital, Harvard Medical School, Boston, MA 02115.
AJR Am J Roentgenol. 1988 Apr;150(4):851-5. doi: 10.2214/ajr.150.4.851.
Ballet dancers are athletes susceptible to ligamentous and bony injury. We reviewed retrospectively the bone scans (technetium-99m methylene diphosphonate) of 23 ballet dancers with pain in the back and/or lower extremities to determine the usefulness of scintigraphy in the detection of stress lesions of bone. The scintigraphic studies in 19 dancers identified multiple areas of stress injury in both symptomatic and asymptomatic locations. Thirteen dancers had 22 stress fractures (microfractures of trabeculae with associated bone repair) manifested by an intense focus of increased uptake of radiopharmaceutical, and 19 dancers had stress reactions (areas of accelerated remodeling and resorption of bone) demonstrated by diffusely increased uptake of radiotracer. Ten of the 13 dancers with stress fractures were symptomatic and six of the 19 dancers with stress reactions were symptomatic. The radiographs of 10 dancers with positive bone scans were normal or showed no distinction between acute and chronic injuries. Stress fractures were most prevalent in the feet, and stress reactions were most prevalent in the tibiae. The study confirmed that ballet dancers sustain significant bone stress in their legs and feet. Our results show that scintigraphy can be used to detect stress fractures and stress reactions at both symptomatic and asymptomatic sites in this population.
芭蕾舞演员是易患韧带和骨骼损伤的运动员。我们回顾性地分析了23名有背部和/或下肢疼痛的芭蕾舞演员的骨扫描（锝-99m亚甲基二膦酸盐），以确定闪烁扫描在检测骨应力损伤中的作用。对19名舞者的闪烁扫描研究发现，在有症状和无症状部位均有多个应力损伤区域。13名舞者有22处应力性骨折（伴有相关骨修复的小梁微骨折），表现为放射性药物摄取增加的强烈浓聚，19名舞者有应力反应（骨加速重塑和吸收区域），表现为放射性示踪剂摄取弥漫性增加。13名有应力性骨折的舞者中有10名有症状，在19名有应力反应的舞者中有6名有症状。10名骨扫描呈阳性的舞者的X线片正常，或未显示急性和慢性损伤之间的区别。应力性骨折在足部最为常见，应力反应在胫骨最为常见。该研究证实，芭蕾舞演员的腿部和足部承受着显著的骨应力。我们的结果表明，闪烁扫描可用于检测该人群有症状和无症状部位的应力性骨折和应力反应。
