Shalaby M, Almekinders L C
Department of Orthopaedic Surgery, University of North Carolina School of Medicine, Chapel Hill, USA.
Am J Sports Med. 1999 May-Jun;27(3):345-9. doi: 10.1177/03635465990270031301.
We evaluated the significance of magnetic resonance imaging findings in patients with patellar tendinitis. Midline sagittal magnetic resonance images were taken of 12 knees from 10 patients and of 17 knees from 15 age- and activity-matched subjects who underwent imaging for reasons other than patellar tendinitis. Of the 12 magnetic resonance imaging scans of knees with clinical patellar tendinitis, 3 (25%) exhibited no defect and only 7 (58%) had unequivocal intratendinous lesions. Among the 17 scans of subjects without clinical patellar tendinitis, 5 (34%) showed no defect and 4 (24%) had unequivocal intratendinous lesions. Proximal tendon width was significantly larger for the tendinitis patient group (5.0 +/- 1.7 mm versus 3.9 +/- 1.0 mm), although considerable overlap was present. All subjects with unequivocal intratendinous signal changes had a significantly longer nonarticular inferior patellar pole and were significantly older (38.1 years versus 26.8 years). Only Blazina stage III lesions were associated with abnormal findings on magnetic resonance imaging. As a whole, the sensitivity and specificity of magnetic resonance imaging was 75% and 29%, respectively. In younger patients with relatively mild symptoms, magnetic resonance imaging did not show significant changes; in older, active patients changes may be present in asymptomatic knees.
我们评估了磁共振成像（MRI）检查结果在髌腱炎患者中的意义。对10例患者的12个膝关节以及15例年龄和活动量匹配、因非髌腱炎原因接受成像检查的对照者的17个膝关节进行了中线矢状面MRI扫描。在12例临床诊断为髌腱炎的膝关节MRI扫描中，3例（25%）未显示异常，只有7例（58%）有明确的肌腱内病变。在17例无临床髌腱炎的对照者扫描中，5例（34%）未显示异常，4例（24%）有明确的肌腱内病变。髌腱炎患者组的近端肌腱宽度显著更大（5.0±1.7mm对3.9±1.0mm），尽管存在相当大的重叠。所有有明确肌腱内信号改变的患者，其髌下极非关节面部分明显更长，且年龄显著更大（38.1岁对26.8岁）。只有Blazina III期病变与MRI异常表现相关。总体而言，MRI的敏感性和特异性分别为75%和29%。在症状相对较轻的年轻患者中，MRI未显示明显变化；在年龄较大、活动较多的患者中，无症状膝关节可能出现改变。
