Katakura Mai, Clark Richard, Lee Justin C, Mitchell Adam W M, Shaw Joseph W, Tsuchida Anika I, Jones Mary, Kelly Shane, Calder James D F
Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Fortius Clinic FIFA Medical Centre of Excellence, London, UK.
Orthop J Sports Med. 2024 Aug 13;12(8):23259671241263593. doi: 10.1177/23259671241263593. eCollection 2024 Aug.
Previous research in sport populations has demonstrated that abnormal magnetic resonance imaging (MRI) findings may be present in individuals without symptoms or known pathology. Extending this understanding to ballet, particularly in relation to the foot and ankle, is important to guide medical advice given to dancers.
To assess foot and ankle MRI scans in asymptomatic ballet dancers focusing on bone marrow edema and the posterior ankle and to investigate whether these MRI findings would become symptomatic within 1 year.
Case series; Level of evidence, 4.
In total, 31 healthy dancers (62 feet/ankles; 15 male and 16 female; age, 26.5 ± 4.3 years) who were dancing in full capacity were recruited from an elite professional ballet company. Orthogonal 3-plane short tau inversion recovery imaging of both feet and ankles was obtained using 3T MRI and the images were reviewed using a standardized evaluation form by 2 musculoskeletal radiologists. Injuries in the company were recorded and positive MRI findings were assessed for correlation with any injuries requiring medical attention during the subsequent 12 months.
A total of 51 (82%) of the 62 feet and ankles had ≥1 area of bone marrow edema. The most common locations of bone marrow edema were the talus (n = 41; 66%), followed by first metatarsal (n = 14; 23%). Os trigonum and Stieda process were seen in 5 (8%) and 8 (13%) ankles, respectively. Among them, 2 os trigona showed bone marrow edema. Fluid in the anterior and posterior talocrural joints and the subtalar joint was observed in 48%, 63%, and 63% of these joints, respectively. Fluid around foot and ankle tendons was observed, with the most prevalent being the flexor hallucis longus tendon (n = 13; 21%). Two dancers who had positive findings on their MRI subsequently developed symptoms during the next 12 months.
Positive MRI findings are commonplace in the foot and ankle of asymptomatic professional ballet dancers. The majority do not result in the development of symptoms requiring medical attention within 12 months. Careful interpretation of MRI findings with the dancer's clinical picture is required before recommending activity modification or further intervention.
先前针对运动员群体的研究表明，无症状或无已知病理状况的个体可能存在磁共振成像（MRI）异常表现。将这一认识扩展至芭蕾舞领域，尤其是足部和踝关节方面，对于指导给予舞者的医疗建议具有重要意义。
评估无症状芭蕾舞舞者的足部和踝关节MRI扫描，重点关注骨髓水肿及踝关节后部，并调查这些MRI表现是否会在1年内出现症状。
病例系列；证据等级，4级。
从一家精英专业芭蕾舞团招募了31名健康且能正常进行舞蹈表演的舞者（62只足/踝关节；15名男性和16名女性；年龄26.5±4.3岁）。使用3T MRI对双足和踝关节进行正交三平面短tau反转恢复成像，并由2名肌肉骨骼放射科医生使用标准化评估表对图像进行评估。记录舞团内的损伤情况，并评估MRI阳性结果与随后12个月内任何需要医疗关注的损伤之间的相关性。
62只足/踝关节中共有51只（82%）存在≥1处骨髓水肿区域。骨髓水肿最常见的部位是距骨（n = 41；66%），其次是第一跖骨（n = 14；23%）。分别在5只（8%）和8只（13%）踝关节中发现了三角骨和Stieda突。其中，2个三角骨出现骨髓水肿。分别在48%、63%和63%的踝关节中观察到距骨前、后关节及距下关节内有积液。观察到足和踝关节周围肌腱有积液，最常见的是拇长屈肌腱（n = 13；21%）。2名MRI检查结果为阳性的舞者在接下来的12个月内随后出现了症状。
无症状专业芭蕾舞舞者的足部和踝关节MRI阳性表现很常见。大多数在12个月内不会发展为需要医疗关注的症状。在建议改变活动或进行进一步干预之前，需要结合舞者的临床表现仔细解读MRI结果。
