髂胫束摩擦综合征的MRI特征及其与膝关节外上髁突出的相关性  

MRI features of iliotibial band friction syndrome and its correlation with lateral epicondyle protrusion of knee joint

作　　者：陈帅[1] 谢胜宇 高超 徐超 余艳凤 张联合[1] CHEN Shuai;XIE Shengyu;GAO Chao;XU Chao;YU Yanfeng;ZHANG Lianhe(Imaging Department,Zhejiang Provincial Corps Hospital of Chinese People’s Armed Police Force,Hangzhou 310051,China)

机构地区：[1]武警浙江总队医院医学影像科,杭州310051

出　　处：《武警医学》2024年第12期1049-1052,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的 分析髂胫束摩擦综合征(ITBFS)的MRI特征,探讨ITBFS与膝关节外上髁突出的相关性。方法 选择2021-01至2023-12武警浙江总队医院临床诊断为ITBFS患者60例(病例组),另选60例有运动史并膝关节疼痛,MRI呈阴性的患者为对照组。两组均行MRI检查,观察分析两组ITBFS的MRI影像学特征,测量并对比膝关节髂胫束厚度、外上髁高度和外侧髁厚度。结果 ITBFS患者的MRI图像上表现为髂胫束不均匀增厚、局部信号增高,髂胫束与股骨外侧髁之间脂肪组织水肿或局限性积液,可伴有髂胫束附着处的骨髓水肿;病例组股骨外侧髁水平髂胫束厚度[(4.23±0.78)mm]较对照组[(2.91±0.43)mm]明显增厚(P<0.01),且慢性期髂胫束厚度[(4.53±0.83)mm]较急性期髂胫束厚度[(3.96±0.62)mm]增厚,差异有统计学意义(P<0.05);病例组膝关节外上髁高度[(14.33±0.95)mm]高于对照组外上髁高度[(12.61±0.98)mm],差异有统计学意义(P<0.05)。两组患者外侧髁厚度相似,但病例组股骨外侧髁高度指数(外上髁高度/外侧髁厚度)显著高于对照组,差异有统计学意义(P<0.05)。结论 膝关节外上髁突出是ITBFS发病的解剖学高危因素,ITBFS的MRI具有典型的影像特征。Objective To analyze MRI features of iliotibial band friction syndrome(ITBFS)and to explore the correlation between ITBFS and lateral epicondylar protrusion of knee joint.Methods A total of 60 patients with clinical diagnosis of ITBFS from January 2021 to December 2023 were selected as case group and another 60 patients with exercise history and knee pain with negative MRI were selected as control group.The MRI imaging features of ITBFS in both groups were observed and analyzed,and the knee iliotibial band thickness,lateral epicondyle height and lateral condyle thickness were measured and compared between the two groups.Results MRI images of ITBFS patients showed uneven thickening of iliotibial band,increased local signal,edema of adipose tissue or localized effusion between iliotibial band and lateral femoral condyle,accompanied by bone marrow edema at the iliotibial band attachment.The horizontal iliotibial tract thickness of lateral femoral condyle[(4.23±0.78)mm]in the case group was significantly thicker than that of control group[(2.91±0.43)mm](P<0.05).The iliotibial tract thickness of chronic phase[(4.53±0.83)mm]was significantly thicker than that of acute phase[(3.96±0.62)mm],and the difference was statistically significant(P<0.05).The lateral condyle height of the knee in the case group[(14.33±0.95)mm]was higher than that of the control group[(12.61±0.98)mm],and the difference was statistically significant(P<0.05).Lateral condyle thickness was similar between the two groups,but the lateral condyle height index(lateral epicondyle height/lateral condyle thickness)in the case group was significantly higher than that in the control group,with statistical significance(0.23±0.02)(P<0.05).Conclusions Protrusion of lateral epicondyle of knee joint is a high risk factor of ITBFS.MRI of ITBFS has typical imaging features.

关 键 词：髂胫束摩擦综合征 膝关节 MRI 运动伤 股骨外上髁 

分 类 号：R445.2[医药卫生—影像医学与核医学] R686.3[医药卫生—诊断学]