McGill University Health Center, Montreal, Quebec, Canada;, Email:
Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
J Dance Med Sci. 2022 Jun 15;26(2):125-133. doi: 10.12678/1089-313X.061522e. Epub 2022 Mar 15.
Bone marrow signal abnormalities on magnetic resonance imaging (MRI) are common in athletes. However, few studies evaluate the MRI appearance of bone marrow in the feet of ballet dancers. Our study aims to describe the "spotty bone marrow" (SBM) pattern in the tarsal bones of a cohort of ballet dancers, establishing its prevalence, distribution, potential associations, and evolution.
Methods: Eighty-six MRIs of 68 ankles in 56 ballet dancers were retrospectively reviewed for mar- row signal alterations, which were classified as focal or SBM (defined as patchy fluid-sensitive signal hyperintensity spanning more than one location or tarsal bone). When SBM involved the talus, its anatomic distribution in the bone and morphologic pattern were recorded. Additional osseous and soft tissue findings were documented. For subjects with more than one MRI of the same ankle, the SBM's evolution was monitored.
Results: Spotty bone marrow was identified in 44 ankles (65%). Spotty bone marrow was isolated to the talus (44%), present in all tarsal bones (25%), or distributed between the talus and one to three other tarsal bones (31%). In the talus, The SBM involved the entire bone (65%), the neck and body (31%), or the head and neck (4%). The SBM most commonly showed a random morphologic pattern (87%) but occasionally showed a peripheral predominance (13%). There was no statistically significant difference in the prevalence of other pathologies in ankles with and without SBM. In eight ankles with a follow-up MRI, the SBM worsened in one, remained stable in two, and improved in five ankles. None progressed to a stress fracture.
Conclusion: Spotty bone marrow is an MRI finding frequently encountered in ballet dancers. It is usually self-limiting and should not be misinterpreted as a more aggressive pathology.
骨髓磁共振成像（MRI）信号异常在运动员中很常见。然而，很少有研究评估芭蕾舞演员足部骨髓的 MRI 表现。我们的研究旨在描述芭蕾舞演员跗骨中的“点状骨髓”（SBM）模式，确定其患病率、分布、潜在关联和演变。
方法：回顾性分析 56 名芭蕾舞演员 68 个踝关节的 86 份 MRI，以评估骨髓信号改变，分为局灶性或 SBM（定义为跨越一个或多个位置或跗骨的斑片状液体敏感信号高信号）。当 SBM 累及距骨时，记录其在骨内的解剖分布和形态模式。记录了其他骨骼和软组织的发现。对于同一踝关节有多个 MRI 的受试者，监测 SBM 的演变。
结果：44 个踝关节（65%）发现点状骨髓。SBM 局限于距骨（44%），存在于所有跗骨（25%），或分布于距骨和一个至三个其他跗骨之间（31%）。在距骨中，SBM 累及整个骨（65%）、颈部和体部（31%）或头部和颈部（4%）。SBM 最常见的形态模式为随机型（87%），但偶尔也表现为周边优势型（13%）。有和无 SBM 的踝关节的其他病变患病率无统计学差异。在 8 个有随访 MRI 的踝关节中，1 个 SBM 恶化，2 个稳定，5 个改善。无一例进展为应力性骨折。
结论：点状骨髓是芭蕾舞演员中常见的 MRI 表现。它通常是自限性的，不应被误诊为更具侵袭性的病理。
