This study investigates whether walking or running prevents the formation of edema in the lower leg. In 18 volunteers changes in calf volume were measured using strain gauge plethysmography during slow (3 km/h) and fast (6 km/h) walking or running (10 km/h) on a treadmill for 20 min each. Venous pressure was measured in a superficial vein near the ankle. Low-pass filtering removed motion artifacts from the signals. Slow walking reduced the calf volume in a biphasic manner: a rapid decrease was followed by a slow decline, lasting from about minute 2 to minute 20, its mean rate being -0.073%/min. Besides a rapid initial decrease, no significant change was observed during fast walking. During running, the calf volume first increased within 7 min to a maximum of 2.5% and subsequently decreased with a mean rate of -0.096%/min. The medians of venous pressure were 84.0, 23.5, 30.4, and 29.5 mmHg during quiet standing, slow and fast walking, and running, respectively. The experimental results prove the hypothesis that walking prevents dependent edema formation. This effect, however, cannot be fully explained by the lowered venous pressures.

BackgroundThe recreational use of trampolines is an increasingly popular activity among children and adolescents. Several studies reported about radiological findings in trampoline related injuries in children. The following publication presents our experience with MRI for detection of trampoline injuries in children.Methods20 children (mean 9.2 years, range: 4–15 years) who had undergone an MRI study for detection of suspected trampoline injuries within one year were included. 9/20 (45%) children had a radiograph as the first imaging modality in conjunction with primary care. In 11/20 (55%) children MR imaging was performed as the first modality. MR imaging was performed on two 1.5 T scanners with 60 and 70 cm bore design respectively without sedation. In 9/20 (45%) children the injury mechanism was a collision with another child. 7/20 (35%) children experienced leg pain several hours to one day after using the trampoline without acute accident and 4/20 (20%) children described a fall from the trampoline to the ground.ResultsAll plain radiographs were performed in facilities outside the study centre and all were classified as having no pathological findings. In contrast, MR imaging detected injuries in 15/20 (75%) children. Lower extremity injuries were the most common findings, observed in 12/15 (80%) children. Amongst these, injuries of the ankle and foot were diagnosed in 7/15 (47%) patients. Fractures of the proximal tibial metaphysis were observed in 3/15 children. One child had developed a thoracic vertebral fracture. The two remaining children experienced injuries to the sacrum and a soft tissue injury of the thumb respectively. Seven children described clinical symptoms without an overt accident. Here, fractures of the proximal tibia were observed in 2 children, a hip joint effusion in another 2, and an injury of the ankle and foot in 1 child. There were no associated spinal cord injuries, no fracture dislocations, no vascular injuries and no head and neck injuries.ConclusionsIn the majority of children referred for MR imaging with pain after trampoline MR imaging detects injuries. These injuries are often not visible on plain radiographs. Therefore we recommend a generous use of MR imaging in these children after initial negative plain radiography.

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