Wirth S, Wieser A, Witt S N, Mutschler W, Reiser M
Institut für Klinische Radiologie-Innenstadt, Ludwig-Maximilians-Universität München, Munich.
Unfallchirurg. 2003 Mar;106(3):238-40. doi: 10.1007/s00113-002-0542-0.
Posttraumatic disorders of the ankle are a common cause of chronic pain. Magnetic resonance imaging (MRI) has proved to be highly useful in clarifying a wide spectrum of underlying lesions which frequently cannot be detected on radiographs. Even if the assessment of the lateral collateral ligaments of the ankle is not regarded as a primary indication for MRI, it allows the diagnosis of subchondral contusions or cysts, anterolateral impingement syndrome, sinus tarsi syndrome, osteochondral fractures and osteochondrosis dissecans of the talus (ODT),which may not be detected with other imaging modalities. A 42 year old female patient suffered from persisting non-specific pain following an inversion trauma 4 months previously. MRI enabled the detection of an ODT which was not diagnosed on plain radiographs and which was verified upon arthroscopy. A superficial cartilage defect, as shown arthroscopically,was not delineated using MRI. Our observations indicate that MRI may be useful in patients with unclear persisting pain following ankle trauma and that it may contribute to the early detection of lesions which require surgical intervention.
踝关节创伤后疾病是慢性疼痛的常见原因。磁共振成像(MRI)已被证明在明确多种潜在病变方面非常有用,而这些病变在X线片上常常无法检测到。即使踝关节外侧副韧带的评估不被视为MRI的主要适应证,但它能诊断出软骨下挫伤或囊肿、前外侧撞击综合征、跗骨窦综合征、距骨骨软骨骨折和距骨剥脱性骨软骨炎(ODT),而这些病变可能无法通过其他成像方式检测到。一名42岁女性患者在4个月前发生内翻创伤后持续存在非特异性疼痛。MRI检测到了X线平片未诊断出的ODT,关节镜检查证实了该病变。关节镜检查显示的浅表软骨缺损,MRI未能显示。我们的观察表明,MRI可能对踝关节创伤后持续疼痛原因不明的患者有用,并且可能有助于早期发现需要手术干预的病变。