Stevens M A, El-Khoury G Y, Kathol M H, Brandser E A, Chow S
Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City 52242, USA.
Radiographics. 1999 May-Jun;19(3):655-72. doi: 10.1148/radiographics.19.3.g99ma05655.
Avulsion injuries are common among participants in organized sports, especially among adolescent participants. Imaging features of both acute and chronic avulsion injuries of the pelvis, knee, ankle and foot, shoulder, and elbow were evaluated to help distinguish these injuries from more serious disease processes such as neoplasm and infection. At radiography, acute injuries (ie, those resulting from extreme, unbalanced, often eccentric muscular contractions) may be associated with avulsed bone fragments, whereas subacute injuries have an aggressive appearance that may include areas of mixed lysis and sclerosis. Chronic injuries (ie, those resulting from repetitive microtrauma or overuse) or old inactive injuries may be associated with a protuberant mass of bone and may bear a striking resemblance to a neoplastic or infectious process. Although not usually required, computed tomography is helpful in the diagnosis if radiographic findings are equivocal or if the injury is not in the acute phase. MR imaging is best suited for the evaluation of injuries to muscles, tendons, and ligaments. Recognition of characteristic imaging features and familiarity with musculotendinous anatomy will aid in accurate diagnosis of avulsion injuries.
撕脱伤在参加有组织体育运动的人群中很常见，尤其是青少年参与者。对骨盆、膝关节、踝关节和足部、肩部及肘部急慢性撕脱伤的影像学特征进行了评估，以帮助将这些损伤与肿瘤和感染等更严重的疾病过程区分开来。在放射摄影中，急性损伤（即由极端、不平衡、通常为离心性肌肉收缩导致的损伤）可能与撕脱的骨碎片有关，而亚急性损伤表现为侵袭性，可能包括溶骨和硬化混合区域。慢性损伤（即由重复性微创伤或过度使用导致的损伤）或陈旧性非活动性损伤可能与突出的骨块有关，可能与肿瘤或感染性病变极为相似。虽然通常不需要，但如果放射学表现不明确或损伤不在急性期，计算机断层扫描有助于诊断。磁共振成像最适合评估肌肉、肌腱和韧带的损伤。认识特征性影像学表现并熟悉肌肉肌腱解剖结构将有助于准确诊断撕脱伤。
