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The influence of long distance running on sonographic joint and tendon pathology: results from a prospective study with marathon runners.

Proft F, Grunke M, Reindl C, Mueller F, Kriegmair M, Leipe J, Weinert P, Schulze-Koops H, Witt M - BMC Musculoskelet Disord (2016)

Bottom Line: The differences were not significant (p > 0.05 each).This observation was more frequent in male than in female participants (p < 0.05).Acute physical stress is significantly associated with hypervascularity of the patellar tendon.

View Article: PubMed Central - PubMed

Affiliation: Division of Rheumatology and Clinical Immunology, Medizinische Klinik und Poliklinik IV, University of Munich, Pettenkoferstr. 8a, D-80336, Munich, Germany.

ABSTRACT

Background: The impact of physical exercise on joints and tendons is still a matter of debate. The aim of this study was to investigate with ultrasound the acute effects of extreme physical exercise on knee and ankle joints and their surrounding structures in trained athletes.

Methods: Participants of the Munich marathon were examined by arthrosonography before and after long distance running. Ultrasound assessment included grey scale and power Doppler examination of the knee and talocrural joints with surrounding tendons. Findings consistent with joint effusion, tendon and/or entheseal pathologies were documented. In addition to the ultrasound evaluation, information on training habits and past or present arthralgia or joint swelling was gathered.

Results: One Hundred Five runners completed both the pre- and post-excercise ultrasound assessments (baseline and follow-up), resulting in the sonographic evaluation of 420 knee and talocrural joints. At baseline, 105 knee (50) and 38 talocrural joints (18.1) showed effusions, compared to 100 knee (47.6) and 33 talocrural joints (15.7 %) at follow-up. The differences were not significant (p > 0.05 each). Effusion size did not correlate with the timepoint of ultrasound assessment and was independent of covariates such as gender, age or running distance. Hypervascularity of the patellar tendon was detected in 21 cases (10.0 %) at follow-up in contrast to one at baseline (p < 0.001). This observation was more frequent in male than in female participants (p < 0.05).

Conclusions: Acute physical stress is significantly associated with hypervascularity of the patellar tendon. No significant changes of synovial effusion were detected in knee and talocrural joints.

No MeSH data available.


Related in: MedlinePlus

Overview of the acquired aspects with their normal ultrasound image. a suprapatellar longitudinal axis (* suprapatellar recessus); b infrapatellar longitudinal axis(* proximal patellar tendon enthesis); c dorsal longitudinal axis of the talocrural joint (* joint margins of the upper talocrural joint); d longitudinal axis of the medial ankle tendons (* posterior tibial tendon); e longitudinal axis of the lateral ankle tendons (* long and short peroneal tendons)
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Fig1: Overview of the acquired aspects with their normal ultrasound image. a suprapatellar longitudinal axis (* suprapatellar recessus); b infrapatellar longitudinal axis(* proximal patellar tendon enthesis); c dorsal longitudinal axis of the talocrural joint (* joint margins of the upper talocrural joint); d longitudinal axis of the medial ankle tendons (* posterior tibial tendon); e longitudinal axis of the lateral ankle tendons (* long and short peroneal tendons)

Mentions: Participants of the Munich marathon, completing either the full distance of 42.195 km or the halfmarathon distance, were examined by arthrosonography before (baseline) and after the run (follow-up). The athletes were actively approached at inscription for the competition and after informed consent was obtained, a baseline ultrasound examination was perfomed 48 to 16 h prior to the start of the race. The follow-up examination was done in the recreational area of the event within two hours after the run. Ultrasound assessment included grey scale (GS) and power Doppler (PD) ultrasound examination of the knees and ankles with surrounding tendons. The ultrasound assessment was performed in a resting, lying position. At the knee, suprapatellar longitudinal and infrapatellar longitudinal aspects were acquired and assessed for presence of suprapatellar recess effusion and hypervascularity of the proximal patellar tendon enthesis, respectively. At the ankle, the longitudinal view on the talocrural joint, and longitudinal and transverse aspects of the medial, dorsal and lateral tendons were assessed for the presence of effusion (Fig. 1). Joint effusions and PD signals in both joint locations were graded semi-quantitatively on a scale ranging from 0 to 3 as described previously [17]. Findings consistent with tendon and/or entheseal pathology were graded both on a binary scale in the grey scale mode and semi-quantitatively from 0 to 3 in the power Doppler mode as described before [18]. In addition to the grading described above, a quantitative measurement of the synovial effusions in millimeters was obtained at the location of the largest diameter in both joints. For an optimal detection of fluid in the knees, subjects were asked to contract their quadriceps muscles for both the semiquantitative and quantitative assessment [19, 20].Fig. 1


The influence of long distance running on sonographic joint and tendon pathology: results from a prospective study with marathon runners.

Proft F, Grunke M, Reindl C, Mueller F, Kriegmair M, Leipe J, Weinert P, Schulze-Koops H, Witt M - BMC Musculoskelet Disord (2016)

Overview of the acquired aspects with their normal ultrasound image. a suprapatellar longitudinal axis (* suprapatellar recessus); b infrapatellar longitudinal axis(* proximal patellar tendon enthesis); c dorsal longitudinal axis of the talocrural joint (* joint margins of the upper talocrural joint); d longitudinal axis of the medial ankle tendons (* posterior tibial tendon); e longitudinal axis of the lateral ankle tendons (* long and short peroneal tendons)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940861&req=5

Fig1: Overview of the acquired aspects with their normal ultrasound image. a suprapatellar longitudinal axis (* suprapatellar recessus); b infrapatellar longitudinal axis(* proximal patellar tendon enthesis); c dorsal longitudinal axis of the talocrural joint (* joint margins of the upper talocrural joint); d longitudinal axis of the medial ankle tendons (* posterior tibial tendon); e longitudinal axis of the lateral ankle tendons (* long and short peroneal tendons)
Mentions: Participants of the Munich marathon, completing either the full distance of 42.195 km or the halfmarathon distance, were examined by arthrosonography before (baseline) and after the run (follow-up). The athletes were actively approached at inscription for the competition and after informed consent was obtained, a baseline ultrasound examination was perfomed 48 to 16 h prior to the start of the race. The follow-up examination was done in the recreational area of the event within two hours after the run. Ultrasound assessment included grey scale (GS) and power Doppler (PD) ultrasound examination of the knees and ankles with surrounding tendons. The ultrasound assessment was performed in a resting, lying position. At the knee, suprapatellar longitudinal and infrapatellar longitudinal aspects were acquired and assessed for presence of suprapatellar recess effusion and hypervascularity of the proximal patellar tendon enthesis, respectively. At the ankle, the longitudinal view on the talocrural joint, and longitudinal and transverse aspects of the medial, dorsal and lateral tendons were assessed for the presence of effusion (Fig. 1). Joint effusions and PD signals in both joint locations were graded semi-quantitatively on a scale ranging from 0 to 3 as described previously [17]. Findings consistent with tendon and/or entheseal pathology were graded both on a binary scale in the grey scale mode and semi-quantitatively from 0 to 3 in the power Doppler mode as described before [18]. In addition to the grading described above, a quantitative measurement of the synovial effusions in millimeters was obtained at the location of the largest diameter in both joints. For an optimal detection of fluid in the knees, subjects were asked to contract their quadriceps muscles for both the semiquantitative and quantitative assessment [19, 20].Fig. 1

Bottom Line: The differences were not significant (p > 0.05 each).This observation was more frequent in male than in female participants (p < 0.05).Acute physical stress is significantly associated with hypervascularity of the patellar tendon.

View Article: PubMed Central - PubMed

Affiliation: Division of Rheumatology and Clinical Immunology, Medizinische Klinik und Poliklinik IV, University of Munich, Pettenkoferstr. 8a, D-80336, Munich, Germany.

ABSTRACT

Background: The impact of physical exercise on joints and tendons is still a matter of debate. The aim of this study was to investigate with ultrasound the acute effects of extreme physical exercise on knee and ankle joints and their surrounding structures in trained athletes.

Methods: Participants of the Munich marathon were examined by arthrosonography before and after long distance running. Ultrasound assessment included grey scale and power Doppler examination of the knee and talocrural joints with surrounding tendons. Findings consistent with joint effusion, tendon and/or entheseal pathologies were documented. In addition to the ultrasound evaluation, information on training habits and past or present arthralgia or joint swelling was gathered.

Results: One Hundred Five runners completed both the pre- and post-excercise ultrasound assessments (baseline and follow-up), resulting in the sonographic evaluation of 420 knee and talocrural joints. At baseline, 105 knee (50) and 38 talocrural joints (18.1) showed effusions, compared to 100 knee (47.6) and 33 talocrural joints (15.7 %) at follow-up. The differences were not significant (p > 0.05 each). Effusion size did not correlate with the timepoint of ultrasound assessment and was independent of covariates such as gender, age or running distance. Hypervascularity of the patellar tendon was detected in 21 cases (10.0 %) at follow-up in contrast to one at baseline (p < 0.001). This observation was more frequent in male than in female participants (p < 0.05).

Conclusions: Acute physical stress is significantly associated with hypervascularity of the patellar tendon. No significant changes of synovial effusion were detected in knee and talocrural joints.

No MeSH data available.


Related in: MedlinePlus