When the Wave Breaks You: Magnetic Resonance Imaging Findings After Surfing Injuries.

BACKGROUND: There are approximately 2.1 million recreational surfers in the United States. However, little has been reported on surfing-related injuries and, to date, no study has utilized magnetic resonance imaging (MRI) to characterize injury patterns. OBJECTIVE: To use MRI to perform a descriptive analysis of surfing injuries in patients who presented to an urban tertiary care musculoskeletal hospital. This was not a hypothesis-driven study. STUDY DESIGN: Case series. LEVEL OF EVIDENCE: Level 4. METHODS: A retrospective review of the picture archiving and communication system as well as the electronic medical record was performed to identify patients with surfing-related injuries who presented to a tertiary care musculoskeletal hospital for treatment. The search included participants over a 10-year period who presented between January 1, 2009, and August 1, 2018. Descriptive data analyses were performed to determine frequency of body part injured, diagnosis, and operative versus nonoperative treatment. RESULTS: The search yielded 109 patients with surfing-related injuries and MRIs. A total of 90 patients presented within 6 months of their surfing injury and were included in the final analysis. The median age was 36 years (range, 12-66 years). A majority of the patients included were male (74%; n = 67). Acute surfing injuries were diagnosed via imaging in 72% (n = 65) of patients. The joints injured most commonly were the shoulder (46%; n = 30) and the knee (28%; n = 18). Only 17% (n = 11) of acute surfing injuries required surgery, while 83% (n = 54) were treated nonoperatively. CONCLUSION: The most common surfing-related injuries occurred in the shoulder and knee. CLINICAL RELEVANCE: This study helps characterize the risk of injury for surfers and informs healthcare providers on common surfing injuries.

Diamagnetic susceptibility artifact associated with graphite foreign body of the orbit.

Imaging in traumatic injury to the orbits plays an important role to identify malformation of the globe, retrobulbar pathology, such as hematoma, the presence of fractures, and identification of foreign bodies. MRI can be especially useful in characterizing soft tissue abnormalities without the use of ionizing radiation. The authors report a case of penetrating injury to the orbit with a retained foreign body where the graphite core of a pencil ("pencil lead") resulted in metal-like diamagnetic susceptibility artifact. This was proven to have no metallic components by CT and surgical exploration. MRI performed in the setting of penetrating injury could aid in localization of a graphite foreign body, and if there is a known graphite foreign body, evaluation of immediately adjacent structures may be obscured.