Sports Injuries Are Olympian Concerns: A Photo Quiz

Question 1:

Knee injuries are the most common injury seen in skiing, and the incidence of anterior cruciate ligament (ACL) injuries is particularly high among competitive alpine skiers. A 3-dimensional CT scan shows a nonanatomical single-bundle AL reconstruction and demonstrates a posterolateral tibial tunnel and a “high” anteromedial femoral tunnel.

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Question 2:

An increase in talus fractures among snowboarders might be related to the use of a soft boot that does not adequately protect the ankle during crashes. Fractures of the talar dome primarily occur on the posterolateral or anteromedial aspect. Often the fracture is not visible on radiographs. It is important to distinguish a talar dome fracture from other ankle problems.

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Question 3:

FOOSH (fall on outstretched hand) injury often results from slipping on ice, as well as skiing and snowboarding. Here a 27-year-old man presented a day after sustaining a FOOSH injury while roller skating. He complained of pain when pronating and supinating his left arm, but there were no limitations in range of motion. A lateral plain x-ray film shows an anterior and posterior fat pad sign on the left elbow. A second image of a posteroanterior view also revealed a slight hematoma positioned medially and just inferior to the radial head.

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Question 4:

Quadriceps muscle strains frequently occur in sports that require repetitive kicking and sprinting. An axial MRI view of a rectus femoris central tendon injury shows fluid enhancement around the central tendon, the acute bull’s-eye lesion (arrow).

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Question 5:

Isolated axillary neuropathy occurs in overhead and other sports. An elite high school pitcher with axillary nerve injury had significant atrophy of the left deltoid and mild atrophy in the teres minor area. His neck was supple, with full range of motion and no pain or stiffness. His reflexes were symmetrical. He had slightly decreased sensation over the lateral aspect of his left deltoid.

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ANSWER KEY:

Question 1. E

Question 2. A

Question 3. D

Question 4. D

Question 5. C