撕脱性骨皮质不规则的影像诊断

Radiology Diagnosis of Avulsive Cortical Irregularity

目的探讨撕脱性骨皮质不规则的临床及影像表现,提高对该病的认识。方法回顾性分析8例撕脱性骨皮质不规则患者的临床及影像学资料,总结其临床及影像学特点。结果 8例患者均为青少年,且有外伤史或慢性损伤史。平均年龄13岁,临床症状为发病部位疼痛。均发生于股骨内侧髁后部,其中双侧发病2例。影像表现主要是肌腱附着处应力过载导致的骨皮质局限性缺损并伴有硬化边,在MRI上表现为脂肪抑制T2WI/PDWI中、高信号伴边缘完整或不完整低信号环,可伴骨膜及骨膜下水肿、骨髓水肿。结论撕脱性骨皮质是一种自限性、完全良性的疾病,根据临床及影像学特点可诊断。

Objective To investigate the clinical and radiological findings of avulsive cortical irregularity.Methods The clinical and imaging findings of eight patients with clinically-confirmed avulsive cortical irregularity were retrospectively analyzed.Results All eight patients had the history of trauma.The patients were all adolescents with unspecific symptoms of anterior knee pain and the average age was 13-year-old.Conventional radiographs and magnetic resonance imaging（MRI） showed all cases as a pathognomonic cortical irregularity of distal femur that most frequently occur in the dorsal,medial supracondylar femur,in which two cases were bilateral.Imaging manifestations showed cortical avulsive injury occurred at the attachment of the adductor magnus aponeurosis or medial head of the gastrocnemius tendon.On MRI,the cases were hypointense on T1-weighted images and hyperintense on T2-weighted images.On both types of images,the lesions have a dark rim at or near the sites of the bony attachment of the medial head of the gastrocnemius muscle.Conclusion Avulsive cortical irregularity is a self-limiting disease.According to the age of onset,anatomical location,clinical manifestations and imaging characteristics,the disease can be diagnosed accurately.