急性髌骨脱位的解剖学因素及核磁影像特征

The abnormal anatomical factors and magnetic resonance imaging characters of acute patellar dislocation

急性髌骨脱位多发于青少年,大多合并有膝关节的解剖学异常。由于多数脱位的暂时性及临床体检、常规影像检查无特异性表现,漏诊率较高,而核磁检查可显示特征性影像特征,准确判别脱位的发生。本文综合国内外文献,对易诱发急性髌骨脱位的解剖学因素及其核磁影像特征进行综述,介绍了股骨滑车发育不良、高位髌骨及胫骨结节外移等主要异常解剖学因素及其判别方法;描述了急性髌骨脱位核磁检查时出现的骨挫伤及骨软骨损伤、内侧支持带复合体损伤、关节游离体、关节血肿及髌骨半脱位、倾斜等影像学特征。

The acute patellar dislocation（ APD） usually occurs in young adults,and most of the cases have the abnormal anatomical factors. The rate of misdiagnosis on APD is high because most dislocations are transient and have not special signs in physical and regular imagining exams. However,the magnetic resonance imaging（ MRI） can detect acute dislocation precisly with the distinctive characters. This review summarizes the reports of abnormal anatomical factors of APD,introduces the major abnormal anatomical factors- trocheal dysplasia,patellar alta and tibial tuberosity lateralization and their measurement methods.Moreover,the classical magnetic resonance imaging characters such as osseous contusion and osteochondral injury,medial reticular cmplex injury,patellar subluxation and tilt,intraarticular bodies and hemarthrosis were delineated in detail.