急性滑脱性髌股关节撞击综合征的3.0T MRI诊断

A study in the diagnosis of acute patellofemoral joint impingent syndrome using 3.0T MRI

目的:探讨急性滑脱性髌股关节撞击综合征的MRI特点及损伤机制。方法:从1782例急性膝关节外伤的MRI资料中筛选出28例经临床MRI诊断急性滑脱性髌股关节撞击综合征的患者,分析其膝关节的MRI表现。结果:28例急性滑脱性髌股关节撞击综合征中,髌骨骨挫伤28例,损伤部位位于髌骨内侧缘皮质下,部分挫伤范围延伸至髌骨嵴。股骨外侧髁挫伤21例,损伤部位位于股骨外侧髁前、中部或前外缘皮质下,部分延伸至外侧髁后部、髁间窝。髌骨内侧缘软骨损伤16例。股骨外侧髁前外侧缘软骨损伤13例。内侧支持带损伤28例,其中I级损伤10例,Ⅱ级损伤13例,Ⅲ级损伤5例。7例外侧支持带损伤,其中I级损伤5例,Ⅱ级损伤2例,未见Ⅲ级损伤。髌骨位置正常19例,向外半脱位5例,完全性脱位4例。关节腔内游离体8例。28例关节积液,其中9例血性积液。结论:MRI能全面显示急性滑脱性髌股关节撞击综合征的损伤机制,为术前诊断及临床治疗提供帮助。

Objective：The aim of this study was to summarize the imaging characteristics of 3.0T MRI and the mech- anism of acute patellofemoral joint impingement syndrome. Methods：A retrospective review of 1782 consecutive MRI exami- nations of acute injured knees was performed to screen 28 patients with acute patellofemoral joint impingement syndrome. The MRI findings were analyzed by two radiologists specialized in diagnosis of musculoskeletal diseases. Results： Among all 28 cases, we found patella bone contusion in 28 cases, presenting an subcortical injury in the medial rim of patellar. Some pa- tellar contusion extended to the rear patellar crest. Injury in the lateral femoral condyle was found in 21 cases. 16 cases had patella medial edge cartilage injury. Cartilage injury in the external femoral condyle was found in 13 cases. Medial retinacu- lum injury was found in all 28 cases,including grade Ⅰ （n=10）,grade H （n=13） and grade Ⅲ （n=5）. Lateral retinaculure injury was also found in 7 cases,including grade [ （n=5） and grade Ⅱ （n： 2）. Patellar was in normal position in 19 cases,outward subluxation in 5 cases,complete dislocation in 4 cases. Free bodies in joint cavity were seen in 8 cases. All 28 cases had joint effusion,with 9 cases of hemorrhagic effusion. Conclusion： MRI can comprehensively display the injury characteristics of acute patellofemoral joint impingent syndrome, which is very helpful for diagnosis and clinical treatment of this disease.