Title : High prevalence of talonavicular sclerosis among other ankle X-Ray abnormalities in asymptomatic male NBA g-league and collegiate basketball athletes
Abstract:
Purpose
Basketball athletes frequently present with asymptomatic radiographic findings, however, the prevalence and type of radiographic abnormalities have been rarely described. Our purpose was to characterize 11 radiographic abnormalities in the foot/ankle in asymptomatic collegiate and NBA G-League basketball athletes.
Methods
Elite-level basketball players (34 collegiate, 20 professional) underwent static radiographic imaging, including antero-posterior, lateral, and mortise views of the ankle. Radiographs were collected from asymptomatic athletes participating in pre-season history and physical with negative anterior drawer/talar tilt test. Radiographs were evaluated by a musculoskeletal radiologist and board-certified orthopedic surgeon; kappa statistics were used to evaluate agreement.
Results
Fifty-four basketball players (mean age 21.5 years) were included, totaling 5,148 player exposures from 2017-2019. 106 ankles presented with radiographic abnormalities (98.15%). The most prevalent radiographic finding was pes planus (47.22%), followed by degenerative joint disease (DJD) (33.33%), talonavicular sclerosis (28.70%), prominent stieda process (25.93%), os trigonum (20.93%), os subfibulare (11.11%), pes cavus (5.56%), subtalar coalition (2.78%), and cavovarus (0.93%). Height ≥ 80” was significantly associated with talonavicular sclerosis and Kellgren-Lawrence 1 changes.
Conclusions
This study demonstrated a strong association between height and talonavicular sclerosis and DJD, as well as a relatively high prevalence of pes planus and DJD in asymptomatic collegiate and professional basketball players. These findings may serve as meaningful data for providers to identify and counsel athletes who may be associated with higher rates of radiographic abnormalities. Although prior prospective studies have not shown correlation of preseason x-ray findings to in-season injury, few studies have exhaustively characterized x-ray abnormalities. Further investigation is warranted to determine whether these lesions remain asymptomatic or, with the continued physical stress that elite basketball play demands, contribute to issues of biomechanical instability or symptomatic pathophysiology of the foot-ankle complex (i.e. rehabilitation following lateral ankle sprains).
Level of Evidence: II; Cross-Sectional Study
Key Terms: Foot, Ankle, Elite Athletes, Basketball, Asymptomatic Abnormalities, Ankle Radiographs
What will the audience learn from your presentation?
Given the overuse and high-impact physical activity associated with basketball training and competitive play, it is imperative that clinicians are able to distinguish between lesions that present asymptomatically at a higher prevalence in basketball athletes from lesions that may cause abnormal pathophysiology to the foot-ankle complex. Information from this study will help guide clinicians when faced with asymptomatic ankle x-ray findings in basketball players. Through understanding the incidence of these abnormalities, competition and training adjustments can be made to avoid future unnecessary stress on the athlete’s foot-ankle complex that progresses asymptomatic lesions to lesions of clinical concern, producing foot and ankle pain.
