Lerer D B, Umans H R, Hu M X, Jones M H
Department of Radiology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, USA.
Skeletal Radiol. 2004 Oct;33(10):569-74. doi: 10.1007/s00256-004-0761-2. Epub 2004 Aug 14.
The purpose of our study was twofold: to better understand the relationship between medial meniscal extrusion (MME) and degenerative joint disease (DJD), and to determine whether a relationship exists between MME and medial meniscal root (MMR) pathology, radial tear and joint effusion.
Two hundred and five consecutive MR imaging examinations of the knee were prospectively evaluated, regardless of indication, for the presence and degree of MME, medial compartment marginal osteophytes, medial compartment articular cartilage loss, joint effusion, medial meniscal tear and MMR pathology. MME >or=3 mm was considered abnormal. All studies were performed using a 1.5 T GE Signa MR unit with a quadrature knee coil. The standard protocol included oblique sagittal, coronal and axial imaging.
We found a strong association ( P<0.0001) between >or=3 mm MME and medial joint line osteophytosis (77%), medial compartment articular cartilage loss (69%), MMR pathology (64%) and radial tear (58%) when compared with knees without these findings. Fifty-one percent of cases with a moderate/large joint effusion had <3 mm MME. We found that 20% (31/155) of patients with minimal or no evidence of DJD had >or=3 mm MME. Of this group, 62% (19/31) had either MMR pathology and/or radial tear, 13% (4/31) had joint effusion as their only abnormality and 6% (2/31) had a normal examination (other than the presence of MME). The remaining 19% consisted of three cases of different types of meniscal tear and three cases of small joint effusions but no other detectable pathology.
MME >or=3 mm is strongly associated with DJD, MMR pathology and radial tear. A significant number of cases with no or minimal evidence of DJD (20%) had >or=3 mm MME, suggesting that MME precedes, rather than follows, the development of DJD. We also found that joint effusion was not strongly associated with >or=3 mm MME.
我们研究的目的有两个：一是更好地理解内侧半月板挤出（MME）与退行性关节病（DJD）之间的关系，二是确定MME与内侧半月板根部（MMR）病变、放射状撕裂及关节积液之间是否存在关联。
前瞻性评估了连续205例膝关节的磁共振成像检查，无论其指征如何，以确定MME的存在及程度、内侧间室边缘骨赘、内侧间室关节软骨损伤、关节积液、内侧半月板撕裂及MMR病变情况。MME≥3mm被视为异常。所有检查均使用配备正交膝关节线圈的1.5T GE Signa磁共振设备进行。标准检查方案包括斜矢状位、冠状位和轴位成像。
与无上述表现的膝关节相比，我们发现MME≥3mm与内侧关节线骨赘形成（77%）、内侧间室关节软骨损伤（69%）、MMR病变（64%）及放射状撕裂（58%）之间存在强关联（P<0.0001）。51%有中度/大量关节积液的病例MME<3mm。我们发现，20%（31/155）DJD证据轻微或无DJD证据的患者MME≥3mm。在该组中，62%（19/31）有MMR病变和/或放射状撕裂，13%（4/31）仅有关节积液这一异常表现，6%（2/31）检查结果正常（除MME外）。其余19%包括3例不同类型的半月板撕裂和3例小关节积液，但无其他可检测到的病变。
MME≥3mm与DJD、MMR病变及放射状撕裂密切相关。相当数量无DJD证据或DJD证据轻微的病例（20%）MME≥3mm，提示MME先于DJD发展，而非继发于DJD。我们还发现关节积液与MME≥3mm之间无强关联。
