Sports injuries can't hide from imaging techniques

Sports injuries often require the use of x-rays and more sophisticated diagnostic imaging studies to determine the nature and severity of the injury. These studies and techniques have evolved significantly over recent years.

Among the most commonly used imaging studies are x-ray, computerized tomography (CT) and magnetic resonance imaging (MRI). X-rays were first used in the late 19th century, primarily to determine fractures and other boney injuries. CT scans came into use in the early 1970s and are designed to measure differences in density, especially in bones. MRIs create images based on changes in tissues such as tearing and swelling.

Dr. Nathaniel Dueker is a board certified musculoskeletal radiologist at The William W. Backus Hospital. He took time to review some of the most common sports injuries that require imaging:

• Head injuries. Concussions are among the most common injuries seen in sports. While there is no image that can diagnose a concussion, a CT scan should reveal any evidence of acute hemorrhage or skull fracture. Persistent symptoms may warrant the eventual use of an MRI to look for chronic damage.

• Shoulder injuries. These injuries typically involve tendons and ligaments. After a plain x-ray to rule out a fracture, an MRI is the best diagnostic tool. This study can demonstrate structural changes in the complex system that makes up the shoulder joint. An MRI of the shoulder can be performed with dye injected into the joint. This exam, called an MRI arthrogram, can be performed in different positions and may reveal subtle tears.

• Knee injuries. Traumatic sports injuries to the knee typically result in ligament and cartilage tears. While x-rays will rule out bone injuries, MRI is an outstanding technique for viewing damage to these structures.

Appropriate diagnostic imaging studies can limit the need for surgery and get athletes back in the game sooner.