运用MRI对肱骨外上髁炎的综合性评价

Application of MRI in Comprehensive Evaluation of Lateral Epicondylitis of the Elbow

目的探讨肱骨外上髁炎MRI的综合表现。方法对经临床诊断的23例肱骨外上髁炎患者共24个肘关节分别行MRI检查,按伸肌总腱损伤程度分为轻、中和重度,观察患者是否合并其他损伤,包括桡侧尺副韧带损伤,桡侧副韧带损伤,内侧副韧带损伤,伸肌损伤、骨质损伤、关节腔积液、肱二头肌腱损伤等。将韧带的损伤分为轻、中和重度三级。对伸肌总腱和桡侧尺副韧带的损伤程度作Spearman等级相关分析,P﹤0.05认为有显著相关。结果伸肌总腱轻度损伤10例,中度7例,重度7例。合并桡侧尺副韧带损伤22例(轻度9例,中度6例,重度7例),桡侧副韧带损伤8例,内侧副韧带损伤3例,伸肌损伤7例,骨质损伤5例,关节腔积液6例,肱二头肌腱损伤1例,肘肌损伤7例。伸肌总腱与桡侧尺副韧带的损伤程度呈正相关(rs=0.852,P﹤0.01)。结论肱骨外上髁炎并非单一的伸肌总腱病变,多合并其他改变,并且随着伸肌总腱损伤的加重,桡侧尺副韧带损伤也加重,对诊疗具有重要的指导作用。

Objective To evaluate comprehensive MRI findings of lateral epicondylitis of elbow. Methods 23 cases of clinical diagnosed lateral epieondylitis including 24 elbows underwent MRI examination. The injury of the common exten- sor tendon was graded as mild, moderate or severe, and associated injuries were observed, such as lateral ulnar collateral ligament, radial collateral ligament, medial collateral ligament, the common extensor muscle, bone, joint effusion, biceps tendon. The injury of the ligament was graded as mild, moderate and severe too. Spearman＇s ank correlative analysis was performed to compare the injury of the common extensor tendon with that of lateral ulnar collateral ligament, correlations were considered significant at P 〈 0.05. Results Mild injury of common extensor tendon were detected in 10 elbows, 7 elbows with moderate injury, and 7 with severe injury. 22 elbows were associated with injury of lateral ulnar collateral liga- ment in which 9 ligaments with mild injury, 6 with moderate injury, 7 with severe injury. 8 injuries in radial collateral liga- ment, 3 in medial collateral ligament, 7 in extensor, 5 in bone, 6 with joint effusion 1 in biceps tendon and 7 in anconeus muscle were simultaneously detected. Spearman$ rank correlation analysis showed positive correlation between the injury of the common extensor tendon and the injury of lateral ulnar collateral ligament （ r, = 0. 852, P 〈 0.01 ）. Conclusion The injury of the common extensor is not a single lesion of epicondylitis, mostly accompanied with other changes, and the more severe the CET injury, the more severe the LUCL injury ,which play an important role in guiding how to treat lateral epicon- dylitis.