HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Nguyen, J. T. Articles by Fredericson, M. Search for Related Content PubMed PubMed Citation Articles by Nguyen, J. T. Articles by Fredericson, M. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Stress-Related Injuries Around the Lesser Trochanter in Long-Distance Runners

¹ Magnetic Resonance Imaging, Radiology, Long Beach Memorial Medical Center, Long Beach, CA.
² Innovative Sports Medicine, Mountain View, CA.
³ Department of Radiology, Stanford University Medical Center, Stanford, CA.
⁴ Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Stanford University Medical Center, 300 Pasteur Dr., Edwards Bldg. R107A, Stanford, CA 94305-5336.

View larger version (115K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1 —36-year-old man with normal lesser trochanter. Axial fat-suppressed T2-weighted MR image shows no decrease in marrow signal intensity at lesser trochanter compared with elsewhere in medullary space. Normal calcar femorale (arrow) should not be mistaken for a fracture line.

View larger version (133K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2 —27-year-old man with normal lesser trochanter. Coronal fat-suppressed T2-weighted MR image shows no decrease in marrow signal intensity at lesser trochanter compared with elsewhere in medullary space.

View larger version (80K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —36-year-old woman marathon runner with groin pain after long run. Coronal (A) and axial (B) T2-weighted fat-suppressed MR images through lesser trochanter obtained at initial presentation show thickening of right iliopsoas tendon and surrounding soft-tissue edema near insertion of tendon on lesser trochanter (solid arrow) and marrow edema at anterior aspect of lesser trochanter (dashed arrow, A).

View larger version (84K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —36-year-old woman marathon runner with groin pain after long run. Coronal (A) and axial (B) T2-weighted fat-suppressed MR images through lesser trochanter obtained at initial presentation show thickening of right iliopsoas tendon and surrounding soft-tissue edema near insertion of tendon on lesser trochanter (solid arrow) and marrow edema at anterior aspect of lesser trochanter (dashed arrow, A).

View larger version (74K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —36-year-old woman marathon runner with groin pain after long run. Coronal (C) and axial (D) T2-weighted MR images through femoral neck obtained at initial presentation show soft-tissue edema surrounding distal right iliopsoas tendon (straight solid arrow) slightly proximal to its insertion and marrow edema extending to inferomedial femoral neck (dashed arrow, C). High signal intensity represents elevation of periosteum (curved arrow, D) off cortex of inferomedial femoral neck.

View larger version (77K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3D —36-year-old woman marathon runner with groin pain after long run. Coronal (C) and axial (D) T2-weighted MR images through femoral neck obtained at initial presentation show soft-tissue edema surrounding distal right iliopsoas tendon (straight solid arrow) slightly proximal to its insertion and marrow edema extending to inferomedial femoral neck (dashed arrow, C). High signal intensity represents elevation of periosteum (curved arrow, D) off cortex of inferomedial femoral neck.

View larger version (74K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3E —36-year-old woman marathon runner with groin pain after long run. Two months after A-D, patient, who had not restricted weightbearing, returned with worsened hip and groin pain. Coronal (E) and axial (F) T2-weighted MR images show area of bone marrow edema in right lesser trochanter (dashed arrow) has enlarged. Abnormal high signal intensity of soft tissues surrounding iliopsoas tendon (solid arrow) has progressed slightly.

View larger version (66K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3F —36-year-old woman marathon runner with groin pain after long run. Two months after A-D, patient, who had not restricted weightbearing, returned with worsened hip and groin pain. Coronal (E) and axial (F) T2-weighted MR images show area of bone marrow edema in right lesser trochanter (dashed arrow) has enlarged. Abnormal high signal intensity of soft tissues surrounding iliopsoas tendon (solid arrow) has progressed slightly.

View larger version (91K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3G —36-year-old woman marathon runner with groin pain after long run. Coronal T2-weighted MR image shows small line of low signal intensity in inferomedial femoral neck (dashed arrow) representing fracture line. Abnormal high signal intensity of soft tissues surrounding iliopsoas tendon (solid arrow) has progressed slightly.

View larger version (72K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3H —36-year-old woman marathon runner with groin pain after long run. T2-weighted MR image shows abnormally high signal intensity of soft tissues surrounding iliopsoas tendon (solid straight arrow) has progressed slightly. Periosteal edema (curved arrow) is more prominent than in D. Dashed arrow indicates line of low signal intensity in inferomedial femoral neck.

View larger version (94K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —21-year-old man on university cross country team presented after 2-week history of right hip pain, which had worsened since patient stopped running. Three-phase bone scan (not shown) depicted increased uptake at insertion of distal iliopsoas muscle and tendon. Coronal fat-suppressed T2-weighted image shows marrow edema in lesser trochanter (solid arrow) extending to inferomedial femoral neck (dashed arrow).

View larger version (108K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —21-year-old man on university cross country team presented after 2-week history of right hip pain, which had worsened since patient stopped running. Three-phase bone scan (not shown) depicted increased uptake at insertion of distal iliopsoas muscle and tendon. Axial fat-suppressed T2-weighted images through lesser trochanter (B) and inferior femoral neck (C) show marrow edema in lesser trochanter (dashed arrow, B) and inferior femoral neck (dashed arrow, C), thickening of iliopsoas tendon (solid arrow), and soft-tissue edema surrounding tendon. Periosteal edema (arrowhead, B) is evident along femoral neck and lesser trochanter.

View larger version (117K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4C —21-year-old man on university cross country team presented after 2-week history of right hip pain, which had worsened since patient stopped running. Three-phase bone scan (not shown) depicted increased uptake at insertion of distal iliopsoas muscle and tendon. Axial fat-suppressed T2-weighted images through lesser trochanter (B) and inferior femoral neck (C) show marrow edema in lesser trochanter (dashed arrow, B) and inferior femoral neck (dashed arrow, C), thickening of iliopsoas tendon (solid arrow), and soft-tissue edema surrounding tendon. Periosteal edema (arrowhead, B) is evident along femoral neck and lesser trochanter.

CiteULike

Complore

Connotea

Del.icio.us

Digg

Reddit

Technorati