青少年膝关节急性应力性骨折临床与MR表现

Clinical And MR Manifestations of Adolescent Knee Joints with Acute Stress Fractures

目的探讨青少年膝关节急性应力性骨折临床和MR特征,提高对该病早期诊断的准确性。方法搜集临床随访复查证实的青少年急性膝关节应力性骨折28例,出现症状1~7天行X线、MR检查,分析其身高、体重、病程、运动爱好等相关临床因素和X线、MR影像表现。结果男18例,女10例,平均年龄14.5岁。男生平均身高161.4cm,平均体重56.7kg,女生平均身高154.3cm,平均体重48.1kg,26例平时不喜活动。28例经X线检查均未发现病变,MR双膝共发现39个病灶,表现为髓质区片状长T_(1)、长T_(2)信号,股骨下端20例(51.3%),胫骨上端18例(46.2%),累及骨骺板9例(23.1%),腓骨上段1例(2.6%),骨膜水肿6例(15.4%),关节积液6例(15.4%)。结论青少年膝关节应力性骨折主要与内在体质有关,MR表现具有一定特征性,早期诊断价值较大。

Objective To explore the clinical and imaging features of acute stress bone injury of knee joint in adolescents,in order to improve the accuracy of early diagnosis.Methods Twenty-eight cases of acute knee joint stress fractures confirmed by clinical follow-up review were collected.X-ray and MR examinations were employed 1~7 days after the symptoms appeared.Clinical factors such as height,weight,duration,and sport hobbies,and X-ray and MR imaging performance are analyzed.Results There were 18 males and 10 females,with an average age of 14.5 years.The average height of male students is 161.4cm,the average weight is 56.7 kg,and the average height of girls is 154.3cm,with an average weight of 48.1 kg.26 cases do not like activities.No lesions were found on the X-rays.A total of 39 lesions were found on the MR knees.Lesions that were in the medullary region signals were long T1 signals and long T2 signals.There were 20 cases(51.3%)in the lower femur,and 18 cases(46.2%)in the upper part of the tibia.9 cases(23.1%)involving the epiphyseal plate,1 case of the upper tibia(2.6%),6 cases of periosteum edema(15.4%),and 6 cases of joint effusion(15.4%).Conclusion Adolescent knee stress fractures are mainly related to internal physical constitution.The MR manifestation has certain characteristics,and its early diagnosis value is relatively large.