Pars Interarticularis Stress Fracture, Pars Interarticularis Stress Injury
Conditions
Keywords
MRI, Pars Interarticularis Stress Fracture, Pars Interarticularis Stress Injury, Pars
Brief summary
The goal of this clinical trial is to learn more about the natural healing process of pars stress injuries in adolescents and young adults by documenting bony bridging across stress fractures using Magnetic Resonance Imaging (MRI). It is hypothesized that many of these injuries can and will heal with appropriate rest and rehabilitation. Long-term, it is hoped that follow-up MRI exams can help guide clinical management by visualizing the healing and allowing individuals to return to play after bony bridging has occurred. Participants will be asked to undergo serial MRI scans over the course of a 12-month period and answer a brief questionnaire at each visit.
Detailed description
There is not a current, well-established standard of care (SoC) for initial diagnosis or follow-up imaging worldwide and these injuries are likely underdiagnosed. Some practices use conventional Magnetic Resonance Imaging (MRI) sequences which can be challenging to interpret, and the patient may undergo repeat testing or alternative imaging including Computed Tomography (CT), bone scans, or repeat MRIs (the former two of which can be high radiation and not optimal at the young age group).
Interventions
DEVICEMRI
Reader confidence using standard lumbar MRI techniques on diagnosing pars stress injuries will be compared to advanced techniques. Additionally, various software/MRI sequences will be tested to evaluate image quality and to improve resolution compared to institution pars MRI scan protocols.
Sponsors
University of Missouri-Columbia
GE Healthcare
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
12 Years to 30 Years
Healthy volunteers
No
Inclusion criteria
* 12-30 years old * Symptoms of back pain at the time of enrollment * Clinical imaging demonstrating pars stress interarticularis injury or pars interarticularis defect
Exclusion criteria
* Prior lumbar surgery * Any condition for which an MRI procedure is contraindicated (e.g., metallic material in the body such as pacemakers, metallic clips, etc.) * Pregnancy * Likelihood of claustrophobia * Any patient-related factors that compromised quality on the initial diagnostic scan (patient motion, ascites fluid, difficulty with positioning during the scan)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pars Stress Injury Healing | From enrollment to 12 months (4 total research scans at 2 months, 4 months, 6 months, and 12 months post initial scan) | Stress injuries (fracture line and/or bone marrow edema) identified prior to study enrollment via initial clinical MRIs will be followed over serial research MRIs at 2 months, 4 months, 6 months, and 12 months after initial clinical MRI was completed. At each MRI, the fracture morphology (incomplete vs complete), bony bridging across any fracture line previously seen, amount of sclerosis, and presence of bone marrow edema will be described to assess degree of injury healing. Patient questionnaires including questions on pain scores will also be administered at the time of the research MRI scans. |
Countries
United States
Contacts
CONTACTHailey N Schlaffer
CONTACTKim Ray
PRINCIPAL_INVESTIGATORLauren Pringle, MD
University of Missouri-Columbia
Outcome results
None listed