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Musculoskeletal Imaging

E2642. Injuries of the Female Athlete: A Review of Imaging Findings

Shampain K,  Udager K,  Denay K,  Yablon C. University of Michigan Health System, Ann Arbor, MI

Address correspondence to K. Shampain (

Background Information: With the rising participation of women in sports at both the recreational and elite levels, there has also been increased awareness of injuries common in the female athlete. Anatomic differences between men and women cause female athletes to be predisposed to certain injuries. Certain behavioral patterns, such as eating disorders, also cause problems specific to female athletes that may result in injury. Imaging plays a large role in diagnosis and ongoing management, but there has been only scant literature dedicated to the specific topic of imaging in female athletes. The purpose of this exhibit is to review the imaging findings and imaging recommendations for injuries and other conditions affecting the female athlete.

Educational Goals/Teaching Points: This exhibit first provides an overview of the key anatomic differences between men and women, including both static and dynamic factors, as well as nonanatomic differences, such as hormonal factors, and discuss how these differences contribute to the injury patterns that are seen more typically in girls and women. The second major teaching point is a review of the imaging findings in injuries that are more commonly seen in female athletes. Injuries discussed include anterior cruciate ligament (ACL) tears, patellofemoral pain syndrome (PFPS), stress fractures, and acetabular labral tears. The final general teaching point focuses on the female athlete triad, which consists of osteoporosis, disordered eating, and amenorrhea and the role of imaging in this condition.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: Important anatomic differences between male and female athletes, which contribute to how athletes of different sexes perform specific motions such as jumping and running, include pelvic width, tibial rotation, knee and hip angles, Q angle, lean body weight, muscle mass proportion in upper versus lower body, and limb length. These anatomic differences are discussed and illustrated with imaging examples. Examples of injuries seen more commonly in female athletes are demonstrated using a variety of modalities with a focus on MRI findings. The female athlete triad is discussed with bone mineral examples demonstrated with dual-energy x-ray absorptiometry scans.

Conclusion: Because of the anatomic, biomechanical, physiologic, and behavioral differences between female and male athletes, injuries in these two populations should be considered with a discerning approach rather than as a uniform population. This exhibit aims to highlight these differences and showcase common injuries in female athletes with a focus on imaging findings and recommendations.