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首页> 外文期刊>Skeletal radiology >Long-term osseous sequelae after acute trauma of the knee joint evaluated by MRI.
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Long-term osseous sequelae after acute trauma of the knee joint evaluated by MRI.

机译：MRI评估膝关节急性创伤后的长期骨后遗症。

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OBJECTIVE. To evaluate the frequency and location and to determine the long-term MR changes in patients with edema-like bone marrow abnormalities after acute knee trauma. DESIGN AND PATIENTS. A cohort of 176 consecutive patients in a 29 month period with acute injury of the knee joint was examined with MRI. Forty-nine patients with bone marrow edema-like signal alteration on the initial MR examination were re-evaluated with MRI after a minimum of 2 years (mean 44 months). Signal alterations and contour abnormalities on the initial and follow-up MR examinations were classified. The volume of the edema was also measured. RESULTS. There was a prevalence of post-traumatic edema-like signal changes of 72% in 176 patients. In the follow-up group ( n=49) the initial MR examination showed 80 areas of signal change with a mean volume of 15.5 cm(3) (range 0.25-175 cm(3)). Thirty-five (44%) were signal changes without other bony or cartilaginous injuries, 19 (24%) were subchondral impaction fractures and 26 (33%) were osteochondral or chondral fractures. Sixty-nine percent of the lesions were located in the lateral, and 29% in the medial joint compartment. Three percent were patellar lesions. In seven of the 49 patients (14%) eight signal changes were seen on the follow-up MR examination. Six lesions were located in the same anatomic area as on the initial MR examination, and two new lesions had developed. The volume of the bone marrow edema was smaller in all persisting lesions (mean volume 2.26 cm(3), range 0.3-4.8 cm(3)). Deterioration of the subchondral impaction, chondral/osteochondral fracture or lesions resembling osteonecrosis were not found in any patient. CONCLUSIONS. The majority of acute post-traumatic marrow signal changes are found in the lateral compartment and do not show additional osseous or chondral alterations. After a minimum of 2 years acute post-traumatic bone marrow edema-like signal alterations vanish in the majority of patients. Even more severe articular surface injuries such as subchondral bone impaction or chondral/osteochondral fractures will heal without obvious osseous long-term sequelae. Post-traumatic osteonecrosis, as reported in the literature, must be a rare event after acute knee trauma.
机译：目的。评估频率和位置，并确定急性膝关节创伤后水肿样骨髓异常患者的长期MR变化。设计和患者。 MRI检查了29个月期间连续176例膝关节急性损伤的患者。至少2年（平均44个月）后，对MR初次检查时出现骨髓水肿样信号改变的49例患者进行了MRI评估。对初次和随访MR检查中的信号改变和轮廓异常进行分类。还测量了水肿的体积。结果。在176例患者中，创伤后水肿样信号改变的患病率为72％。在随访组（n = 49）中，最初的MR检查显示80个信号变化区域，平均体积为15.5 cm（3）（范围为0.25-175 cm（3））。 35例（44％）为信号变化，无其他骨或软骨损伤，19例（24％）为软骨下冲击性骨折，26例（33％）为骨软骨或软骨骨折。 69％的病变位于外侧，29％位于内侧关节腔。 percent骨病变占3％。在49例患者中的7例（14％）中，随访MR检查发现有8个信号变化。与最初的MR检查时相同的解剖区域中有6个病变，并且出现了两个新的病变。在所有持续存在的病变中，骨髓水肿的体积较小（平均体积为2.26 cm（3），范围为0.3-4.8 cm（3））。在任何患者中均未发现软骨下撞击恶化，软骨/骨软骨骨折或类似骨坏死的病变。结论。创伤后大多数急性骨髓信号改变均在外侧室中发现，未显示出其他骨或软骨改变。至少2年后，大多数患者的急性创伤后骨髓水肿样信号改变消失了。甚至更严重的关节表面损伤（如软骨下骨撞击或软骨/骨软骨骨折）也将he愈，而不会出现明显的长期骨后遗症。如文献报道的，创伤后骨坏死必须是急性膝盖创伤后罕见的事件。

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