Pudas T, Hurme T, Mattila K, Svedström E
Department of Radiology, University of Turku, Turku, Finland.
Acta Radiol. 2005 Oct;46(6):636-44. doi: 10.1080/02841850510021643.
Magnetic resonance imaging (MRI) evaluation of pediatric elbow trauma with or without a visible fracture on radiography.
MRI was performed in the acute phase in 25 children with an elbow injury. Nine patients with an elbow effusion only on radiographs and 16 with a fracture or luxation seen on radiographs underwent subsequent MRI. No sedation was used.
MRI revealed eight occult fractures (89%) in seven out of nine patients who had only an effusion on radiographs. Based on MRI findings, septic arthritis was suspected in one patient. Two patients out of five with a supracondylar fracture on the radiograph had a cartilage lesion in the humerus. MRI depicted a 3-mm gap on the articular surface in two patients with a lateral condyle fracture, a more accurate fracture location in two patients than the radiographs, and an additional occult fracture in two patients. MRI showed a fracture not seen on radiographs in two of three patients with prior luxation.
MRI is a sensitive and accurate method in the diagnosis of pediatric elbow injuries, especially when only an effusion is present on radiographs. Occult fractures are more common in pediatric patients with elbow injury than reported earlier.
对儿科肘部创伤进行磁共振成像（MRI）评估，无论X线摄影是否可见骨折。
对25例肘部受伤儿童在急性期进行MRI检查。9例X线片仅显示肘部积液的患者以及16例X线片显示骨折或脱位的患者随后接受了MRI检查。未使用镇静剂。
MRI在9例X线片仅显示积液的患者中的7例中发现了8处隐匿性骨折（89%）。根据MRI结果，1例患者疑似感染性关节炎。5例X线片显示髁上骨折的患者中有2例肱骨存在软骨损伤。MRI在2例外侧髁骨折患者的关节表面显示出3毫米的间隙，在2例患者中骨折位置比X线片更准确，并且在2例患者中发现了额外的隐匿性骨折。MRI在3例既往有脱位的患者中的2例中显示出X线片未发现的骨折。
MRI是诊断儿科肘部损伤的一种敏感且准确的方法，尤其是当X线片仅显示积液时。隐匿性骨折在儿科肘部损伤患者中比早期报道的更为常见。
