男性职业足球运动员慢性踝关节损伤CT表现分析

CT findings of chronic ankle injury in male professional football players

目的分析男性职业足球运动员慢性踝关节损伤CT表现。方法选择55例男性职业足球运动员作为实验组,另选择42例正常男性志愿者作为对照组。两组均进行CT检查,比较两组踝关节骨质异常发生率,分析实验组骨赘、关节游离体发生情况。结果对照组距骨骨软骨损伤发生率为9.52%(4/42),骨赘发生率为45.24%(19/42),游离体发生率为19.05%(8/42),三角骨发生率为7.14%(3/42),关节下囊变发生率为2.38%(1/42);实验组距骨骨软骨损伤发生率为5.45%(3/55),骨赘发生率为89.09%(49/55),游离体的发生率40.00%(22/55),三角骨发生率58.18%(32/55),关节面下囊变发生率5.45%(3/55)。两组距骨骨软骨损伤和关节面下囊变发生率比较差异无统计学意义(P>0.05);实验组骨赘、游离体及三角骨发生率均显著高于对照组,差异有统计学意义(P<0.05)。实验组骨赘主要分布在距骨前后缘、胫骨前后缘。距骨前后缘1级骨赘发生率为47.27%(26/55),2级骨赘发生率为21.82%(12/55),3级骨赘发生率为20.00%(11/55);距骨前缘骨赘发生率为85.45%(47/55),其中1级24例,2级12例,3级11例;距骨后缘骨赘发生率为3.64%(2/55),其中1级2例,2级0例,3级0例。胫骨前后缘1级骨赘发生率为56.36%(31/55),2级骨赘发生率为10.91%(6/55),3级骨赘发生率为5.45%(3/55);胫骨前缘骨赘发生率为72.73%(40/55),其中1级31例,2级6例,3级3例;胫骨后缘骨赘发生率为0。1级游离体发生率为61.82%(34/55),2级游离体发生率为10.91%(6/55),3级游离体发生率为9.09%(5/55);关节内侧游离体发率为9.09%(5/55),其中1级3例,2级2例,3级0例;关节外侧游离体发生率为5.45(3/55),其中1级2例,2级0例,3级1例;关节前方游离体发生率为10.91%(6/55),其中1级4例,2级0例,3级2例;关节后方游离体发生率为16.36%(9/55),其中1级5例,2级2例,3级2例;关节腔内游离体发生率为12.73%(7/55),其中1级7例,2级0例,3级0例;关节腔外游离体发生率为27.27%(15/55),其中1级13例,2级2例,3级0例。结论男性职业足球运动员骨赘、游离体、三角骨发生率明显高于正常人群,其发生情况与足球运动员长期训练与比赛有关,这些骨质异常可能会引起踝关节疼痛或产生踝关节撞击综合征。

Objective To analyze CT findings of chronic ankle injury in male professional football players.Methods 55 male professional football players were selected as the experimental group,and 42 normal male volunteers were selected as the control group.CT examination was performed in both groups.The incidence of osseous abnormality of ankle was compared between the two groups.The incidence of osteophyte and loose body of the experimental group was analyzed.Results In the control group,the incidence of osteocartilaginous and subchondralo bone injury of ankle bone was 9.52%(4/42),the incidence of osteophyte was 45.24%(19/42),the incidence of loose body was 19.05%(8/42),the incidence of triquetrum was 7.14%(3/42)and the incidence of subarticular cystic degeneration was 2.38%(1/42).In the experimental group,the incidence of osteocartilaginous and subchondralo bone injury of ankle bone was 5.45%(3/55),the incidence of osteophyte was 89.09%(49/55),the incidence of loose body was 40.00%(22/55),the incidence of triquetrum was 58.18%(32/55)and the incidence of subarticular cystic degeneration was 5.45%(3/55).The differences in the incidences of the osteocartilaginous and subchondralo bone injury of ankle bone and the subarticular cystic degeneration between the two groups were not statistically significant(P>0.05).The incidences of osteophyte,loose body and triquetrum of the experimental group were significantly higher than those of the control group,and the differences were statistically significant(P<0.05).In the experimental group,the osteophytes mainly located at the anterior and posterior edges of ankle bone and tibia.At the anterior and posterior edges of ankle bone,the incidence of grade 1 osteophyte was 47.27%(26/55),the incidence of grade 2 osteophyte was 21.82%(12/55),and the incidence of grade 3 osteophyte was 20.00%(11/55).At the anterior edge of ankle bone,the incidence of osteophyte was 85.45%(47/55),including 24 cases of grade 1 osteophyte,12 cases of grade 2 osteophyte and 11 cases of grade 3 osteophyte.At the posterior edge of ankle bone,the incidence of osteophyte was 3.64%(2/55),including 2 cases of grade 1 osteophyte,0 case of grade 2 osteophyte and 0 case of grade 3 osteophyte.At the anterior and posterior edges of tibia,the incidence of grade 1 osteophyte was 56.36%(31/55),the incidence of grade 2 osteophyte was 10.91%(6/55),and the incidence of tertiary osteophyte was 5.45%(3/55).At the anterior edge of tibia,the incidence of osteophyte was 72.73%(40/55),including 31 cases of grade 1 osteophyte,6 cases of grade 2 osteophyte and 3 cases of grade 3 osteophyte.At the posterior edge of tibia,the incidence of osteophyte was 0,including 0 case of grade 1,grade 2 and grade 3 osteophyte.The incidence of grade 1 loose body was 61.82%(34/55),the incidence of grade 2 loose body was 10.91%(6/55),and the incidence of grade 3 loose body was 9.09%(5/55).The incidence of loose body inside the joint was 9.09%(5/55),including 3 cases of grade 1 loose body,2 cases of grade 2 loose body and 0 case of grade 3 loose body.The incidence of loose body outside the joint was 5.45%(3/55),including 2 cases of grade 1 loose body,0 case of grade 2 loose body and 1 case of grade 3 loose body.The incidence of loose body in front of the joint was 10.91%(6/55),including 4 cases of grade 1 loose body,0 case of grade 2 loose body and 2 cases of grade 3 loose body.The incidence of loose body behind the joint was 16.36%(9/55),including 5 cases of grade 1 loose body,2 cases of grade 2 loose body and 2 cases of grade 3 loose body.The incidence of loose body in the articular cavity was 12.73%(7/55),including 7 cases of grade 1 loose body,0 case of grade 2 loose body and 0 case of grade 3 loose body.The incidence of extraarticular loose body was 27.27%(15/55),including 13 cases of grade 1 loose body,2 cases of grade 2 loose body and 0 case of grade 3 loose body.Conclusion The incidences of osteophyte,loose body and triquetrum in male professional football players are significantly higher than those in the normal population.The occurrence is related to the long-term training and competition of football players.These osseous abnormalities may cause ankle pain or ankle impingement syndrome.