Buckland-Wright Chris
Department of Applied Clinical Anatomy, School of Biomedical Sciences, Hodgkin Building, King's College London, London Bridge, London SE1 1UL, UK.
Best Pract Res Clin Rheumatol. 2006 Feb;20(1):39-55. doi: 10.1016/j.berh.2005.08.002.
Based upon published data, the different methods of imaging the knee joint are evaluated with respect to the radiographic procedure and anatomical structures recorded in: (1) images from radiographs of the tibiofemoral joint that have been obtained from the non-weight-bearing and weight-bearing extended knee views and the standardized knee flexion positions using fluoroscopy (semi-flexed and Lyon Schuss views) and non-fluoroscopic methods (MTP and fixed flexion); and (2) images from radiographs of the patellofemoral joint obtained from the lateral and the different axial views of the joint. Non-weight-bearing and weight-bearing radiographs of the knee in extension were found to be of limited value in assessing disease status, whereas all standing flexed knee positions reliably imaged joint space width and bone changes in the tibiofemoral joint. Fluoroscopic positioning of the joint is more demanding on equipment and personnel than non-fluoroscopic methods. Skyline rather than lateral views of the patellofemoral joint were better at detecting joint changes in osteoarthritis. It is concluded that for both clinical practice and research purposes the non-fluoroscopic MTP and fixed flexion methods are recommended for imaging the tibiofemoral compartment, and the standing skyline view is recommended for the patellofemoral joint.
根据已发表的数据，针对膝关节成像的不同方法，从以下方面进行评估：（1）放射成像程序以及所记录的解剖结构，这些结构来自胫股关节的X线片，通过非负重和负重伸直膝关节视图以及使用荧光透视法（半屈曲和Lyon Schuss视图）和非荧光透视法（MTP和固定屈曲）的标准化膝关节屈曲位置获得；（2）髌股关节X线片的图像，这些图像来自关节的外侧和不同的轴向视图。研究发现，膝关节伸直时的非负重和负重X线片在评估疾病状态方面价值有限，而所有站立屈曲膝关节位置都能可靠地显示胫股关节的关节间隙宽度和骨质变化。与非荧光透视法相比，荧光透视法对关节的定位对设备和人员要求更高。髌股关节的天际线视图而非外侧视图在检测骨关节炎的关节变化方面效果更好。结论是，出于临床实践和研究目的，建议采用非荧光透视法的MTP和固定屈曲方法对胫股关节进行成像，对于髌股关节建议采用站立天际线视图。
