急性滑脱性髌股关节撞击症的影像学表现  

The imaging performance and mechanism of acute slipped patellofemoral joint impingent syndrome

作　　者：李敏[1] 邓德茂[1] 米昆[2] 袁文昭[1] 万荣超[1] 何欣[1] 武莹莹[1] 

机构地区：[1]广西中医药大学第一附属医院放射科,广西南宁530023 [2]广西中医药大学第一附属医院骨科,广西南宁530023

出　　处：《实用放射学杂志》2014年第7期1169-1172,共4页Journal of Practical Radiology

摘　　要：目的：探讨急性滑脱性髌股关节撞击症的影像学特征。方法回顾性分析10例经临床证实的急性滑脱性髌股关节撞击症临床及影像学资料。结果10例患者均有明确屈曲外翻扭伤病史。10例患者中,髌骨脱位或者半脱位改变,DR 发现9例, MRI 发现10例；髌骨急性滑脱所致髌骨内侧骨折或骨软骨骨折,DR 发现1例,MRI 发现2例3处；MRI 发现10例髌内侧支持带损伤,与手术所见一致；9例患者 MRI 在特定部位（股骨外髁前外侧面及髌骨内下侧）发现软骨损伤及软骨下骨髓水肿,1例髌骨内下侧出现软骨损伤及软骨下骨髓水肿,软骨损伤与关节镜所见一致；3例患者 MRI 发现前交叉或后交叉韧带损伤,4例外侧半月板撕裂,所有患者均有不同程度关节积液,与关节镜所见一致。结论 MRI 能较好地显示急性滑脱性髌股关节撞击所致特征性软骨损伤及软骨下骨髓水肿,有助于临床早期诊断及治疗。Objective To study the imaging performance and mechanism of acute patellofemoral joint impingent syndrome.Meth-ods The MR images and clinical data of acute patellofemoral joint impingent syndrome were analysed retrospectively in 10 patients, which were confirmed by clinic .MRI and DR examination were performed in all patients,in which 6 patients had complete knee ar-throscopy material.The imaging performance and mechanism of acute patellofemoral joint impingent syndrome were summarized re-spectively.Results All cases had clear history of buckling ectropion trauma;Patellar dislocation or subluxation were detected in 9 cases on DR examination,10 cases on MRI;Patellar medial fracture or osteochondral fracture caused by acute slipped patella was de-tected in 1 case on DR examination,2 cases （3 places）on MRI;Medial patellar retinaculum injury were detected in 10 cases on MRI,which were corresponding to that on surgery.Articular injury and subchondral marrow edema in particular parts of joint （an-terolateral of lateral femoral and medial patellar）were detected in 9 cases on MRI.MRI features of articular cartilage injury were confirmed by arthroscopy.MRI showed ACL or PCL injury in 3 cases,meniscus tear in 4 cases,which were quite consistent with the arthroscopy findings.Conclusion MRI can effective display joint cartilage damage,subchondral marrow edema in particular parts of the joint,which is useful to clinical prediction and treatment at early stage.

关 键 词：急性滑脱性髌股关节撞击症 软骨损伤 磁共振成像 

分 类 号：R681.8[医药卫生—骨科学] R681.3[医药卫生—外科学]