Asymptomatic sonographic abnormalities of the hindfoot region in Division I collegiate gymnasts

PM R. 2023 Oct 5. doi: 10.1002/pmrj.13077. Online ahead of print.

Abstract

Background: The hindfoot region is commonly injured in gymnasts, and musculoskeletal ultrasound can be used to identify structural abnormalities in this region. Although prior studies have shown that sonographic abnormalities may not correlate with symptomatic pathology, the presence of asymptomatic sonographic abnormalities of the hindfoot in Division I collegiate gymnasts has not been evaluated.

Objective: To identify and describe commonly seen asymptomatic sonographic abnormalities of the hindfoot region in Division I collegiate gymnasts.

Design: Cross-sectional study.

Setting: Tertiary care academic medical center.

Participants: 39 Division I NCAA men's and women's collegiate gymnasts without current hindfoot pain or history of hindfoot injury.

Interventions: Diagnostic musculoskeletal ultrasound of the hindfoot region.

Main outcome measures: Sonographic appearance of the hindfoot region, specifically the plantar fascia, plantar fad pad, and Achilles tendon.

Results: A total of 37 of 39 gymnasts included in the study were found to have at least one asymptomatic sonographic abnormality of the hindfoot region. A total of 28.2% of athletes were found to have sonographic abnormalities within the Achilles tendon, with Doppler flow being the most common finding, and 35.8% of athletes were found to have a Haglund's deformity. However, only 7% of athletes with a Haglund's deformity demonstrated abnormal sonographic findings within the tendon. Sonographic abnormalities of the plantar fascia and plantar fat pad were seen in 30.7% and 69.2% of athletes, respectively.

Conclusions: Asymptomatic sonographic abnormalities of the hindfoot region are common in collegiate gymnasts. Clinicians should use clinical judgment when interpreting these findings as they may not represent symptomatic pathology.