As the Winter Olympic Games wraps up in PyeongChang, we had the chance to admire some of the top athletes in the world perform incredible physical feats and represent their countries. However, what we may not appreciate is the large risk of injury present in such competitions, and the medical support that operates behind the scenes. Researchers from the Boston Medical Center analyzed the on-site imaging of injuries at the Rio de Janiero 2016 Summer Olympic Games and found that it played an important role.

Track and field athletes were imaged the most overall. Image credits: Pixabay.

In the last Summer Olympic games, 11,000 athletes participated and a grand total of 1,101 injuries were sustained by 718 athletes. On-site medical staff have the responsibility to access the injury and make sure that the athlete can safely return to the competition, or go for therapy or surgery. They often base their decisions on the results of imaging. Having these resources on-site ensures fast decision making and treatment. Nearly every injury sustained in the last Games was imaged. The lion’s share of imaging exams were MRIs (59.8%), 30% were X-rays, and 10.2% were ultrasound. Imaging was used to diagnose 6.4% of athletes in total, so it was a very important resource.

Some sports are more dangerous than others in terms of the probability and type of injury sustained. The lower limb and upper limb were the two most imaged locations. Most (about 84%) of muscle and stress injuries were in the lower half of the body. Athletes in athletics, soccer, and weightlifting had the most muscle injuries. Stress injuries were the most common in athletics, volleyball, artistic gymnastics, and fencing. Fractures were common in athletics, hockey, and cycling.

“Two peaks of imaging utilization were observed, on the fifth and 12th days of the games,” said Dr. Guermazi, M.D., Ph.D., professor and vice chair in the Department of Radiology at Boston University School of Medicine, in Boston, Mass., and musculoskeletal radiologist at Boston Medical Center. “This likely corresponds with the timing of judo and athletics events, with both sports showing high proportional utilization rates. These findings will help to plan for increased availability of imaging services during those expected peaks.”

Images of a sprinter with acute anterior thigh pain while training. The arrowheads show muscle rupture while arrows show retraction. (a) Ultrasound image (b) Fat-suppressed T2-weighted MR imaging. Image credits: Radiological Society of North America.

Artistic gymnastics had the highest percentage of athletes who utilized imaging (15.5 %), followed by Taekwondo (14.2 %) and beach volleyball (13.5 %). Track and field athletes had the most examinations, 293 in all.

“In some sports, like beach volleyball or Taekwondo, the high utilization rate was somewhat unexpected,” Dr. Guermazi said. “These numbers may help in planning imaging services for future events and will also help in analyzing further why some sports are at higher risk for injury and how these injuries can possibly be prevented.”

There are quite a large number of athletes that become injured during the Olympic Games, about 1 in 15. Imaging services are almost exclusively used to diagnose the injury quickly and accurately. Therefore, having them on-site is an indispensable resource.

Journal reference: “Sports Injuries at the Rio de Janeiro 2016 Summer Olympics: Use of Diagnostic Imaging Services.” Collaborating with Dr. Guermazi were Daichi Hayashi, M.D., Ph.D., Mohamed Jarraya, M.D., Michel D. Crema, M.D., Roald Bahr, M.D., Ph.D., Frank W. Roemer, M.D., Joao Grangeiro, M.D., Richard Budgett, M.D., Torbjorn Soligard, M.D., Ph.D., Romulo Domingues, M.D., Abdalla Skaf, M.D., and Lars Engebretsen, M.D., Ph.D. (2018) Radiology.