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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2001 February;52(1):1-6
Calcaneal fractures. Evaluation with magnetic resonance imaging
Cusmano F., Bellelli A., Pedrazzini M., Armaroli S., Affanni M., Devoti D.
Background. To assess the role of MRI in evaluation of calcaneal fractures in comparison with conventional radiography and CT.
Methods. Twenty-five patients (18 men, 7 women; average age 36 years) with foot and ankle derangement have been studied: 9 of them had a major trauma that involved other skeletal segments and 16 a minor trauma as ankle sprains or contusions. All patients underwent standard radiography and MRI; in 9 patients spiral-CT was also carried out. MRI was performed in acute phase in patients with major trauma and after 8-60 days in those with minor trauma. In 17 cases MRI was performed with a 1,5-T superconducting magnet and in other 8 patients with a low-field dedicated extremity MRI system of 0,2-T. In all cases T1 and T2-weighted images in axial, coronal and sagittal planes were obtained.
Results. In patients with major trauma 7 intra-articular fractures and 2 bone contusions of the calcaneus were recognised; in those with minor trauma 3 extra-articular fractures, 2 stress fractures, one reflex sympathetic dystrophy, 2 os trigonum syndrome, 2 talo-calcaneal coalitions, one talo-calcaneal chondromalacia and 5 degenerative osteoarthritis of the talo-calcaneal joint were detected.
Conclusions. MRI is similar to CT in the evaluation of calcaneal fractures but it gives more information about ischemia of bone fragments or associated lesions of tendons and ligaments. Moreover MRI enables to recognise contusions and fractures undetectable with CT and to study optimally later complications of calcaneal injuries.