MR Features And Related Factors Of Ankle Injuries In Asymptomatic Amateur Marathon Runners

Objective To analyse the MR manifestations and factors of ankle injuries in asymptomatic amateur marathon runners.Methods The 113 amateur marathon runners?63 males,50 females?without any ankle joint symptoms in local region were recruited.All subjects underwent MRI scans of the ankle joint.The ankle joint special phased array coil was used to perform T₁-weighted imaging?T₁WI?,fat-suppressed protein density-weighted imaging sequence?fs-PDWI?and fat-suppressed T₂-weighted imaging sequence?fs-T₂WI?.To summarize the MRI manifestations of ankle injuries and Logistic regression analysis was applied to analyze the factors of ankle injuries.The potential related factors included sex,age,running years,running pace,the weekly running distance and foot strike pattern.Result Bone changes were mainly bone marrow edema and cystic change.The bone marrow edema was mainly grade 1 or 2 and more common in the distal tibia?12 ankles?,talus?29 ankles?and calcaneus?35 ankles?.There were 10 ankles of cystic change.Tendon changes were mainly peritendinous effusion.There were 145 ankles of posterior tibialis tendon sheath effusion,78 ankles of flexor digitorum longus tendon sheath effusion,131 ankles of flexor hallucis longus tendon sheath effusion,32 ankles of peroneus longus and peroneus brevis tendon sheath effusion,19 ankles of anterior tibialis tendon sheath effusion,10 ankles of extensor hallucis longus tendon sheath effusion and 17 ankles of extensor digitorum longus tendon sheath effusion.Achilles tendon changes were mainly manifested as Achilles tendinopathy?49 ankles?and Achilles tendon effusion?21 ankles?.Ligament injury was mainly manifested as partial lateral collateral ligament injury,which was mainly grade 1 or 2.87 ankles were anterior talofibular ligament injuriy,46 ankles were posterior talofibular ligament injury,72 ankles were calcaneofibular ligament injury and 28 ankles were deltoid ligament injury.Others include cartilage damage on 6 ankles and subcutaneous soft tissue edema on 25 ankles.The risk factor of bone marrow edema in amateur marathon runners was rearfoot strike pattern?P=0.028,OR=1.172?;the risk factors of peritendinous effusion were the weekly running distance of?60 km?P=0.013,OR=1.685?and increased running years?P=0.039,OR=1.113?,whereas rearfoot strike pattern?P=0.005,OR=0.831?was a protective factor for peritendinous effusion;the risk factor of Achilles tendinopathy was increased age?P=0.008,OR=1.412?;the risk factors of anterior talofibular ligament injury were rearfoot strike pattern?P=0.017,OR=1.346?and the weekly running distance of?60 km?P=0.022,OR=1.171?;the factors of calcaneofibular ligament injury were the weekly running distance of?60 km?P=0.029,OR=1.570?and rearfoot strike pattern?P=0.035,OR=1.463?.Conclusion Asymptomatic amateur marathon runners have been easily lead to ankle injury due to long-term repeated training and competition.The main MR imaging features are bone marrow edema,peritendinous effusion,and partial lateral collateral ligament injury.In addition,increased age,increased running years,higher weekly running distance and different foot strike pattern are the risk factors of ankle injuries.The correct understanding of these related factors can effectively prevent injuries and guide amateur marathon runners in scientific training and competition.