COMPARATIVE STUDY BETWEEN THE PUBIS OF ASYMPTOMATIC ATHLETES AND NON-ATHLETES WITH MRI

ABSTRACTObjective: To compare the magnetic resonance imaging findings from the pubis of professional soccer players without any history or clinical findings of groin pain, and from sedentary individuals, also without symptoms, and to determine the prevalence of changes compatible with pubic overload. Methods: Nineteen professional soccer players without complaints of groin pain and seventeen sedentary individuals, also asymptomatic, underwent magnetic resonance imaging of the pubis. The results from the examinations were analyzed regarding the presence of degenerative changes, boned medullary edema and tendinopathy, and the two study groups were compared. Results: High prevalence of bone edema, tendinopathy and degenerative findings in the pubic symphysis was seen in the athletes, with statistically significant higher odds ratios and relative risk in the population studied. Conclusion: Professional soccer players are at a higher risk of developing changes in the pubic region, shown in magnetic resonance images, compared with sedentary individuals. These findings are not necessarily caused by groin pain, and are probably related to intense exertion

Swimming as Treatment of Scapular Dyskinesis

Scapular dyskinesis is quite frequent and can lead to shoulder pain. The diagnosis is essentially clinical. The main cause is muscle imbalance, between the trapezius, rhomboids, and pectoralis minor. In these cases, rehabilitation is the best treatment. We present a case of a young male patient with dyskinesis due to axonal involvement of the long thoracic nerve and paresis of the anterior serratus muscle. After a swimming program to increase muscular strength and imbalance, he experienced pain reduction and functional recovery of the upper limb, with reduction of the winged scapula

Topographic study of the isometry testing in anatomic reconstructions of the anterior cruciate ligament of the knee

Purpose was to describe the perioperative isometry testing in anatomic reconstructions of the anterior cruciate ligament of the knee (ACL) using a single-bundle technique (MAXTEST). Anatomic ACL transtibial tunnel reconstruction was performed in 16 human cadaver knees. To assess the isometry, the length of Ethibond 2 ® suture thread passed through the tibial tunnel and attached to a guidewire placed at the estimated center point of the original ACL footprint on the lateral femoral condyle was measured one centimeter from the external tibial tunnel exit in the knee maximal 26 flexion and extension. The femoral entrance was modified before the perforation of the femoral tunnel to an anterior or posterior position until an isometric behaviour was observed. We called this assessment the MAXTEST. The obtained measurements were statistically analyzed. Additionally, a correlation test was conducted between the following: (1) the height from the guidewire exit point to the anterior surface of the lateral femoral condyle and the anteroposterior diameter of the lateral femoral condyle; (2) the distance from the articular surface of the tibia to the intercondylar roof and the distance between the guidewire and the intercondylar roof. The performed statistical analysis showed that the anatomic reconstruction pattern could be isometric (p-value=0.654). A linear positive correlation was found between the height from the guidewire exit point to the anterior surface of the lateral femoral condyle and the anteroposterior diameter of the lateral femoral condyle (R2=0.677, multiple R=0.823, adjusted R2=-1.154, standard error=2.72). Additionally, a positive correlation was observed between the distance from the articular surface of the tibia to the intercondylar roof and the distance between the guidewire and the intercondylar roof (R2=0.96, multiple R=0.98, adjusted R2=-1.143, standard error=0.319). We concluded that “MAXTEST” is a reproducible isometry test in anatomic single- bundle ACL reconstructions when performed before the femoral tunnel perforation

Estudo comparativo por ressonância magnética de púbis entre atletas e sedentários assintomáticos Comparative study between the pubis of asymptomatic athletes and non-athletes with MRI

OBJETIVO: Comparar os achados na ressonância magnética do púbis de atletas profissionais de futebol, sem histórico ou clínica de pubalgia, com sedentários também assintomáticos, determinando a prevalência de alterações compatíveis com sobrecarga púbica. MÉTODOS: Dezenove atletas profissionais de futebol, sem queixas álgicas na região púbica, e 17 sedentários, também assintomáticos, foram submetidos à ressonância magnética do púbis. Os resultados dos exames foram analisados quanto à presença de alterações degenerativas, edema medular ósseo e tendinopatia, comparando ambos os grupos estudados. RESULTADOS: Foi encontrada alta prevalência de edema ósseo e tendinopatia, bem como alterações degenerativas da sínfise púbica no grupo de atletas, encontrando-se valores maiores de odds ratio e risco relativo, com significância estatística na população estudada. CONCLUSÃO: Atletas profissionais de futebol apresentam maior risco de desenvolver alterações na região púbica, evidenciadas na ressonância magnética, se comparados a indivíduos sedentários. Estes achados não são obrigatoriamente causa de pubalgia, estando provavelmente relacionados a esforço intenso.<br>OBJECTIVE: To compare the magnetic resonance imaging findings of the pubis of professional soccer players, without history of or clinical groin pain, and non-athletes, also without symptoms, determining the prevalence of changes compatible with pubic overload. METHODS: Nineteen professional soccer players without complaints of groin pain and seventeen non-athletes, also asymptomatic, underwent pubic magnetic resonance images. Exam findings were analyzed for the presence of degenerative changes, medullar edema and tendinopathy, comparing both groups. RESULTS: High prevalence of bone edema, tendinopathy and degenerative findings in the pubic symphysis was seen in athletes, with statistically significant higher odds ratios and relative risk for the population studied. CONCLUSION: Professional soccer players are at a higher risk for developing changes in the pubic region, evidenced in magnetic resonance images, when compared to non-athletes. Those findings are not necessarily related to groin pain, and are probably related to intense stress