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首页> 外文期刊>AJR: American Journal of Roentgenology : Including Diagnostic Radiology, Radiation Oncology, Nuclear Medicine, Ultrasonography and Related Basic Sciences >Extraarticular lateral hindfoot impingement with posterior tibial tendon tear: MRI correlation.
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Extraarticular lateral hindfoot impingement with posterior tibial tendon tear: MRI correlation.

机译：胫骨后肌腱撕裂与关节后外侧外侧脚碰撞：MRI相关性。

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OBJECTIVE: Posterior tibial tendon dysfunction with secondary hindfoot valgus can lead to painful extraarticular, lateral talocalcaneal, and subfibular impingements, often necessitating surgical intervention. The purpose of this study was to correlate findings of lateral hindfoot impingement with grading of posterior tibial tendon tears and severity of hindfoot valgus on MRI. MATERIALS AND METHODS: MR images from 75 patients (45 women and 30 men) with MRI evidence of posterior tibial tendon tears were evaluated for grade of posterior tibial tendon tear, hindfoot valgus angle, osseous contact or opposing marrow signal changes at the talus-calcaneus or fibula-calcaneus, peroneal tendon subluxation-dislocation, and presence of lateral malleolar bursa. Statistical analyses were performed using Cochran-Armitage, Fisher's exact, and Mann-Whitney tests. RESULTS: Twenty-eight cases (37%) of lateral hindfoot impingement were identified, including six talocalcaneal, eight subfibular, and 14 talocalcaneal-subfibular impingements. The prevalence of impingement was significantly increased with greater MRI hindfoot valgus angle (p < 0.001). The prevalence of talocalcaneal-subfibular impingement significantly increased with grading of posterior tibial tendon tear (p = 0.018). Peroneal tendon subluxation was present only with advanced hindfoot valgus (p = 0.010) and impingement (p = 0.004). There was no significant association between the presence of lateral malleolar bursa and hindfoot valgus severity. CONCLUSION: Extraarticular lateral hindfoot impingement is associated with advanced posterior tibial tendon tears and increased MRI hindfoot valgus angle. Peroneal tendon subluxation likely represents an end stage of lateral impingement in patients with posterior tibial tendon dysfunction.
机译：目的：胫后肌腱功能不全伴继发性后足外翻可导致关节外，外侧肩local骨和腓骨下的疼痛，通常需要手术干预。这项研究的目的是在MRI上将外侧后足撞击的发现与胫骨后肌腱撕裂的等级和后足外翻的严重程度相关联。材料与方法：对75例患者（45名女性和30名男性）的MRI图像进行了MRI证实，胫骨后肌腱撕裂的MR图像评估了胫骨后肌腱撕裂的程度，后足外翻角，骨接触或距骨-跟骨的相对骨髓信号变化或腓骨跟骨，腓腱半脱位和侧踝滑囊的存在。使用Cochran-Armitage，Fisher精确检验和Mann-Whitney检验进行统计分析。结果：确定了28例（37％）的后足外侧撞击，包括6处管，8处腓骨和14处管-腓骨以下累及。 MRI的后足外翻角越大，撞击的发生率就越明显（p <0.001）。胫骨后腓骨撕裂的发生率随胫后肌腱撕裂程度的增加而显着增加（p = 0.018）。腓骨腱半脱位仅在晚期后足外翻（p = 0.010）和撞击（p = 0.004）时出现。外踝滑囊的存在与后足外翻的严重程度之间没有显着相关性。结论：关节外侧外侧后足撞击与胫后肌腱晚期撕裂和MRI后足外翻角度增加有关。腓骨肌腱半脱位可能代表了胫骨后肌腱功能障碍患者的侧向撞击的终结阶段。

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