World Cup Special Edition: Soccer Player with a Sesamoid Injury
The 2014 FIFA World Cup officially begins Thursday, June 12. The world’s top soccer players will all be in Rio, Brazil for one of the biggest sporting events of the decade. The next two weeks will be filled with cheering fans, tears of joy, and national pride. But inevitably, there will also be injuries. In fact, before the games even begin, a number of players already know they will have to sit them out. For professional athletes and weekend warriors alike, an accurate diagnosis from the onset can make a huge impact on the speed of recovery. When it comes to bony injuries of the foot and ankle, the pedCAT is the only tool in the world that can provide a weight bearing, three dimensional image of the entire foot. Here’s a case of a 30-year-old soccer player, who was treated by a California podiatrist. The athlete injured his right great toe and sesamoids while playing soccer. The doctor observed that the patient’s first metatarsophalangeal joint was swollen and ecchymotic, and that he was tender upon palpation of the great toe joint and sesamoid bones. The doctor took standard non-weight bearing X-Ray images of the patient. The AP and lateral X-Rays showed an obvious fracture with displacement in the medial sesamoid. The lateral appeared to have a fracture, but the doctor could not confirm his suspicion with the X-Ray. The doctor also took an axial X-Ray, but it had no diagnostic benefit since the patient could not extend his great toe. double sesamoid fracture x-ray The doctor then took a pedCAT scan of the same patient. The CT images clearly showed a severely displaced right medial sesamoid oblique fracture and a minimally displaced lateral sesamoid fracture. The oblique lateral sesamoid fracture demonstrated 2 mm of plantar displacement with excellent bony contact/ apposition in the dorsal 4 mm of the sesamoid. pedCAT double sesamoid fracturepedCAT lateral sesamoid fracture displacement Although the diagnostic information provided by the pedCAT did not alter the treatment plan for the medial sesamoid, it did confirm the injury to the lateral sesamoid. More importantly, the pedCAT was able to provide diagnostic information regarding the geometric nature of the lateral sesamoid fracture. “I could determine that there was enough bony contact to allow for bone healing with appropriate conservative care management,” the doctor said.