Sijbrandij E S, van Gils A P, Louwerens J W, de Lange E E
Department of Radiology, University Hospital Utrecht and Central Military Hospital, Heidelberglaan 100, 3509 AA Utrecht, The Netherlands.
AJR Am J Roentgenol. 2000 Dec;175(6):1707-10. doi: 10.2214/ajr.175.6.1751707.
The objective of this study was to determine the presence and location of subchondral bone contusions, fractures, and "kissing" lesions of the talotibial joint after a sprain of the ankle shown on MR imaging.
We retrospectively reviewed the images of all consecutive patients who underwent MR imaging of the ankle after acute or recurrent sprain occurring between January and December 1997. The number and location of subchondral contusions or fractures revealed on MR imaging were recorded, and a comparison was made with the radiographs obtained for each patient.
Of the 146 ankles, 42 osteochondral lesions were revealed on MR imaging in 26 ankles (18%) involving 23 patients. Twenty-three lesions were localized in the dome of the talus and 19, in the tibiofibular plafond. In 16 (11%) of the 146 ankles, the lesions were present in the opposing bones of the joint ("kissing" lesions). Only six of the 12 talar fractures and none of the tibial fractures involving the 26 ankles were seen on conventional radiography.
Subchondral lesions in the talus and tibia are relatively common after ankle trauma, occurring in 18% of patients in our series. Kissing lesions were present in more than half of the lesions in these patients.
本研究的目的是确定踝关节扭伤后在磁共振成像（MR成像）上显示的距胫关节软骨下骨挫伤、骨折及“亲吻”损伤的存在情况及位置。
我们回顾性分析了1997年1月至12月期间因急性或复发性踝关节扭伤而接受踝关节MR成像检查的所有连续患者的图像。记录MR成像上显示的软骨下挫伤或骨折的数量及位置，并与每位患者的X线片进行比较。
在146个踝关节中，26个踝关节（18%）的MR成像显示有42处骨软骨损伤，涉及23名患者。23处损伤位于距骨穹顶，19处位于胫腓骨远端关节面。在146个踝关节中的16个（11%），损伤存在于关节的相对骨面（“亲吻”损伤）。在26个踝关节中，12处距骨骨折中只有6处、胫骨骨折无一在传统X线片上显影。
距骨和胫骨的软骨下损伤在踝关节创伤后相对常见，在我们的系列研究中占患者的18%。这些患者中超过一半的损伤存在“亲吻”损伤。
