Blankstein A, Cohen I, Heim M, Diamant L, Salai M, Chechick A, Ganel A
Department of Orthopaedic Surgery, Sheba Medical Center, Tel-Hashomer, Israel.
Arch Orthop Trauma Surg. 2001 Oct;121(9):536-9. doi: 10.1007/s004020100285.
Sonographic examination of the knee has been proposed by several authors in the past as a simple and reliable method to diagnose Osgood-Schlatter disease (OSD). Ultrasound was used to compare the knees of 25 boys and 10 girls with typical OSD with 35 symptom-free knees of an aged-matched group of children. Based on recorded data, patients were categorized (one affected knee in each individual) according to the classification system proposed by De Flaviis et al. in 1989. The results included the following pathological findings: pretibial swelling, fragmentation of the ossification center, insertional thickening of the patellar tendon, and excessive fluid collection in the infrapatellar bursa. Of our patients, 26% fell into the type 1 category, 43% were type 2, 20% type 3, and 11% type 4. This distribution of cases was found to be statistically similar to the initial findings reported by De Flaviis and colleagues. This study therefore supports the validity and reproducibility of their classification method for the ultrasonographic evaluation of children with OSD. This is only the first step, and further assessment of this classification is still required to elucidate its clinical as well as its prognostic value.
过去已有多位作者提出，膝关节超声检查是诊断胫骨结节骨软骨炎（OSD）的一种简单可靠的方法。本研究采用超声对25名患有典型OSD的男孩和10名患有典型OSD的女孩的膝关节，与35名年龄匹配的无症状儿童的膝关节进行了比较。根据记录的数据，按照De Flaviis等人于1989年提出的分类系统，对患者（每人一个患侧膝关节）进行了分类。结果发现了以下病理表现：胫骨前肿胀、骨化中心碎裂、髌腱附着处增厚以及髌下囊积液过多。在我们的患者中，26%属于1型，43%属于2型，20%属于3型，11%属于4型。发现这种病例分布在统计学上与De Flaviis及其同事最初报告的结果相似。因此，本研究支持了他们对OSD患儿进行超声评估的分类方法的有效性和可重复性。这仅仅是第一步，仍需要对该分类进行进一步评估，以阐明其临床价值和预后价值。
