Westcott M A, Dynes M C, Remer E M, Donaldson J S, Dias L S
Department of Radiology, Northwestern Memorial Hospital, Northwestern University Medical School, Chicago, IL.
Radiographics. 1992 Nov;12(6):1155-73. doi: 10.1148/radiographics.12.6.1439018.
This article presents a radiologic review of the spectrum of acquired and congenital orthopedic abnormalities found in patients with myelomeningocele. These abnormalities are caused predominantly by muscle imbalance, paralysis, and decreased sensation in the lower extremity. Iatrogenic injury, such as a postoperative tethered cord, may also cause bone abnormalities. Selected images were obtained from more than 800 children. Important entities presented include spinal curvatures such as kyphosis, scoliosis, and lordosis; subluxation and dislocation of the hip, coxa valga, contractures of the hip, and femoral torsion; knee deformities; rotational abnormalities of the lower extremity and external and internal torsion; ankle and foot abnormalities such as ankle valgus, calcaneus foot, congenital vertical talus (rocker-bottom deformity), and talipes equinovarus; and metaphyseal, diaphyseal, and physeal fractures. Familiarity with congenital abnormalities and an understanding of the pathogenesis of acquired disorders in patients with myelomeningocele are essential for proper radiologic interpretation and timely therapy.
本文对脊髓脊膜膨出患者所发现的获得性和先天性骨科异常的范围进行了影像学综述。这些异常主要由下肢肌肉失衡、麻痹和感觉减退引起。医源性损伤，如术后脊髓拴系，也可能导致骨骼异常。从800多名儿童中获取了选定的影像。呈现的重要病症包括脊柱后凸、脊柱侧凸和脊柱前凸等脊柱弯曲；髋关节半脱位和脱位、髋外翻、髋关节挛缩和股骨扭转；膝关节畸形；下肢旋转异常以及内外扭转；踝关节和足部异常，如足外翻、跟骨足、先天性垂直距骨（摇椅底畸形）和马蹄内翻足；以及干骺端、骨干和骨骺骨折。熟悉先天性异常并了解脊髓脊膜膨出患者获得性疾病的发病机制对于正确的影像学解读和及时治疗至关重要。
