Abstract Update

Abstract 161 has been withdrawn. Dr. Imran Omar is presenting the following instead:
Musculoskeletal: Trauma, Infection, Arthritis
161: A Pattern of Sternal Injuries in Professional Football Players
*Omar, IM¹; Zoga, AC¹; DeLuca, PF²; Morrison, WB¹
* Represents the presenting author(s).
Address correspondence to: Omar IM (imran.omar@mail.tju.edu)
¹Thomas Jefferson University Hospital, Department of Radiology, Philadelphia, PA; ²Thomas Jefferson University Hospital, Department of Orthopedic Surgery, Philadelphia, PA.
Objective: Professional football players experience mechanistic injuries rarely seen in other athletic or non athletic activities. We will describe a pattern of traumatic injuries to the sternum, sternoclavicular joints and surrounding soft tissues in professional football players seen by MRI.
Materials and Methods: Four professional football players suffered traumatic injuries to the sternal or sternoclavicular region during games, and were subsequently imaged by both noncontrast MRI and CT within 24 hours of initial injury. All MRI examinations were performed at 1.5 Tesla using a protocol tailored to the sternum and sternoclavicular joint in three planes. CT examinations were performed with a bone algorithm on multidetector row systems, and both sagittal and coronal reconstructions were acquired. All studies were reviewed on a PACS workstation.
Results: Two of the CT examinations were normal. In both of these patients MRI demonstrated sternal hematomas along with a manubriosternal stepoff in one case and manubriosternal joint fluid in the other. Pectoralis muscle strains were also seen on MRI of both patients. In the third patient both CT and MRI detected costosternal cartilage injury. However, MRI also showed strap muscle tears not evident on CT. The patient had a small pneumothorax which was only seen on CT. The fourth patient had a sternoclavicular dislocation seen on both CT and MRI, but MRI also revealed a sternoclavicular capsular avulsion and strains of the pectoralis major and sternocleidomastoid muscles.
Conclusion: CT is widely considered the standard of care imaging modality for traumatic injuries involving the sternum and surrounding structures. We present a series of professional football injuries with MRI findings not diagnosed with CT. We propose MRI with a protocol tailored to the sternum and sternoclavicular joints is indicated as an adjunctive modality in patients with trauma to this region.