Petrolo Antonio
RCCSS(C) Sports Sciences Resident, Canadian Memorial Chiropractic College.
J Can Chiropr Assoc. 2022 Aug;66(2):157-171.
Injuries to the meniscus are particularly prevalent in soccer players, with an incidence of 0.448 injuries per 1000 hours of playing. However, in the adolescent soccer player population, it has been reported that up to 63% of asymptomatic knees may demonstrate horizontal or oblique tears on MRI. These results may negatively influence clinical decision-making and plan of management for adolescent soccer players with knee problems.
A case of a 15-year-old soccer player is presented after having been diagnosed by his family physician with a left lateral meniscus tear as per MRI, following a 10-week period of anterior knee pain. He presented to a chiropractor for a second opinion before consulting with the orthopedic surgeon.
Recommendations for progressive rehabilitation owing to the lack of clinical evidence for meniscal abnormality were made. A primary diagnosis of left patellar tendinopathy was determined and after a 6-week comprehensive rehabilitation program, the patient made a complete recovery.
A thorough history, physical examination, and understanding of the patient's injury mechanism are suggested before confirming/refuting suspicions of meniscal abnormalities via MRI. This will help to inform better clinical decision-making as well as decrease the occurrence of unnecessary imaging.
半月板损伤在足球运动员中尤为普遍,每1000小时比赛的损伤发生率为0.448例。然而,在青少年足球运动员群体中,据报道,高达63%无症状的膝盖在磁共振成像(MRI)上可能显示水平或斜向撕裂。这些结果可能对有膝盖问题的青少年足球运动员的临床决策和管理计划产生负面影响。
一名15岁足球运动员,在经历了10周的前膝疼痛后,其家庭医生根据MRI诊断为左外侧半月板撕裂。在咨询骨科医生之前,他向一名脊椎按摩师寻求第二种意见。
由于缺乏半月板异常的临床证据,建议进行渐进性康复治疗。确定主要诊断为左髌腱病,经过为期6周的综合康复计划,患者完全康复。
在通过MRI确认/排除半月板异常的怀疑之前,建议进行全面的病史询问、体格检查,并了解患者的损伤机制。这将有助于做出更好的临床决策,并减少不必要的影像学检查的发生。