急性髌骨一过性脱位多种影像学诊断价值对比

Acute Transient Dislocation of Patella: Comparison Study of Multiple Imaging Means

目的对比分析急性髌骨一过性脱位的多种影像学表现,以提高诊断水平。方法回顾性分析39例急性髌骨一过性脱位患者的X线、CT及MRI资料,由两名放射科医师共同确定髌骨位置、骨折、骨软骨骨折、骨髓水肿、髌骨内侧支持带的损伤、关节积液及其他合并损伤情况。结果 X线片显示半脱位18例,髌骨内侧缘及股骨外髁骨折2例。CT显示髌骨半脱位19例,髌骨内侧缘骨折11例,股骨外髁骨折3例,内侧软组织增厚肿胀29例。MRI显示髌骨半脱位19例,髌骨内侧缘骨软骨骨折9例,髌骨内侧份及股骨外髁骨髓水肿39例,内侧髌股支持带增厚肿胀损伤33例。结论 X线及CT能够直观显示髌骨位置异常和骨折。MRI可更全面准确地显示髌骨脱位及周围韧带异常,特别是股骨外髁和髌骨内下份骨髓水肿具特征性。

Objective To analyze the multiple imaging manifestations of acute transient dislocation of patella in order to improve the diagnostic level. Methods The X-ray, CT and MRI materials of 39 cases with acute transient dislocation ofpatella were retrospectively analyzed. The patellar position, bone fracture, osteochondral fracture, bone marrow edema, medial patellar retinaculum tear, joint effusion and other associated injury signs were determined by two radiologists together. Results X-ray films revealed sub-dislocation of the patella in 18 cases and fractures at the medial edge of the patella and femoral condyle in 2 cases. CT scanning showed sub-dislocation of patella in 19 cases, fracture of the medial edge ofthe patella in 11 cases, fracture of femoral condyle in 3 cases and medial soft tissue swelling in 29 cases. MRI examination displayed sub-dislocation of patella in 19 cases, osteochondral fracture of medial margin of patella in 9 cases, bone marrowedema of medial patella and lateral femoral condyle in 39 cases and swelling of thickened medial patellar retinaculum in 33 cases. Conclusion X-ray and CT scan can directly show the abnormal position and fractures of patella. MRI can be more comprehensively and accurately display the dislocation of patella, the abnormal ligament around the knee joint and especially the bone marrow edema of medial patella and lateral femoral condyle.