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Radiologists are frequently called on for guidance regarding return to play (RTP) for athletes and active individuals after sustaining a musculoskeletal injury. Avoidance of reinjury is of particular importance throughout the rehabilitative process and following resumption of competitive activity. Understanding reinjury risk estimation, imaging patterns, and correlation of clinical and surgical findings will help prepare the radiologist to identify reinjuries correctly on diagnostic imaging studies and optimize management for a safe RTP. [ABSTRACT FROM AUTHOR]

Purpose: To compare diagnostic performance of a 5-min knee MRI protocol to that of a standard knee MRI.Materials and Methods: One hundred 3 T (100 patients, mean 38.8 years) and 50 1.5 T (46 patients, mean 46.4 years) MRIs, consisting of 5 fast, 2D multi-planar fast-spin-echo (FSE) sequences and five standard multiplanar FSE sequences, from two academic centers (1/2015-1/2016), were retrospectively reviewed by four musculoskeletal radiologists. Agreement between fast and standard (interprotocol agreement) and between standard (intraprotocol agreement) readings for meniscal, ligamentous, chondral, and bone pathology was compared for interchangeability. Frequency of major findings, sensitivity, and specificity was also tested for each protocol.Results: Interprotocol agreement using fast MRI was similar to intraprotocol agreement with standard MRI (83.0-99.5%), with no excess disagreement (≤ 1.2; 95% CI, -4.2 to 3.8%), across all structures. Frequency of major findings (1.1-22.4% across structures) on fast and standard MRI was not significantly different (p ≥ 0.215), except more ACL tears on fast MRI (p = 0.021) and more cartilage defects on standard MRI (p < 0.001). Sensitivities (59-100%) and specificities (73-99%) of fast and standard MRI were not significantly different for meniscal and ligament tears (95% CI for difference, -0.08-0.08). For cartilage defects, fast MRI was slightly less sensitive (95% CI for difference, -0.125 to -0.01) but slightly more specific (95% CI for difference, 0.01-0.5) than standard MRI.Conclusion: A fast 5-min MRI protocol is interchangeable with and has similar accuracy to a standard knee MRI for evaluating internal derangement of the knee. [ABSTRACT FROM AUTHOR]

Objective: Injuries at the calcaneocuboid and talonavicular joint have been described as two distinct, unrelated entities in the radiology literature. Our purpose was to assess the coexistence of these injuries using radiography and MRI and to correlate our findings with radiologic and clinical diagnoses., Materials and Methods: Twenty-one patients with injury at the anterior calcaneal process on radiographs or MR images were retrospectively assessed for concomitant injury at the talonavicular joint. Radiologic and clinical diagnoses and treatment were documented. McNemar and kappa statistics were calculated; p values < 0.05 were considered statistically significant., Results: Radiographic and MRI rates of detection of injuries across the Chopart joint were statistically different. Calcaneocuboid avulsion fractures were evident on 48% of radiographs and 100% of MR images (p = 0.001). Talonavicular joint injuries were evident on 38% of radiographs and 76% of MR images (p = 0.008). Concomitant injury at both joints was evident on 14% of radiographs and 76% of MR images (p < 0.0001). Interrater agreement was 0.488-0.637 and 0.286-0.364 for talonavicular and 0.144-0.538 and 0.976-1 for calcaneocuboid injuries on radiography and MRI, respectively. Sixty percent of calcaneocuboid fractures were prospectively missed on radiography (none on MRI), whereas 38% and 25% of talonavicular findings were missed on radiography and MRI, respectively. Sixty percent of injuries were clinically misdiagnosed as ankle sprains. Chopart joint injury was never mentioned in prospective clinical or imaging diagnoses., Conclusion: Calcaneocuboid and talonavicular injuries commonly coexist. Radiographs underestimate severity of injury; MR images show more subtle abnormalities. Lack of mention of Chopart joint injury clinically and on imaging reports underlies the need for greater familiarity with this entity.

Objective: This study determined the frequency and MRI appearance of osseous and ligamentous injuries in midtarsal (Chopart) sprains and their association with ankle sprains after acute ankle injuries. Prospective diagnosis of and interobserver agreement regarding midtarsal injury among musculoskeletal radiologists were also assessed., Subjects and Methods: Two cohorts with ankle MRI were identified via a digital PACS search: patients who had undergone MRI within 8 weeks after ankle injury and control subjects who had not sustained ankle trauma. Studies were retrospectively reviewed in consensus as well as independently, assessing ligamentous and osseous injury to the Chopart joint (calcaneocuboid and talonavicular joints) and associated lateral collateral and deltoid ligamentous injury. Interobserver agreement was calculated, and prospective radiology reports were reviewed to determine the musculoskeletal radiologist's familiarity with Chopart joint injury., Results: MR images of control subjects (n = 16) and patients with ankle injury (n = 47) were reviewed. The normal dorsal calcaneocuboid and calcaneocuboid component of bifurcate ligaments were variably visualized; the remaining normal ligaments were always seen. Eleven patients (23%) had midtarsal ligamentous and osseous injury consistent with midtarsal sprain (eight acute or subacute, one probable, and two old). Six (75%) of eight acute or subacute cases had coexisting lateral collateral ligament injury. Eighty-nine percent of osseous injuries were reported prospectively, but 83% of ligamentous injuries were missed. Substantial interobserver agreement was achieved regarding diagnosis of midtarsal sprain., Conclusion: Midtarsal sprains are commonly associated with acute ankle injury and with ankle sprains. Presently, midtarsal sprains may be underrecognized by radiologists; thus, greater familiarity with the MRI spectrum of ligamentous and osseous injuries at the Chopart joint is important for accurate diagnosis and clinical management.

Objective: The purpose of this article is to review current and emerging techniques and strategies that can be used to accelerate acquisition times in routine knee MRI., Conclusion: Specific techniques reviewed include 3D fast spin-echo imaging as well as new approaches to rapid image acquisition techniques (parallel imaging, compressed sensing, simultaneous multislice, and neural network reconstruction techniques) and their potential application to knee MRI.