Shellock F G, Morris E, Deutsch A L, Mink J H, Kerr R, Boden S D
Tower Musculoskeletal Imaging Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
AJR Am J Roentgenol. 1992 Feb;158(2):335-8. doi: 10.2214/ajr.158.2.1729795.
In a prior study of marathon runners, we noticed that MR scans of the knee frequently showed hyperplasia of red (i.e., hematopoietic) bone marrow. Because the frequency of this finding in various populations is unknown, the purpose of this study was to determine the relative prevalences of hematopoietic bone marrow hyperplasia on MR examinations of the knees of healthy volunteers (n = 74), patients with symptoms of knee disorders (n = 54), and asymptomatic marathon runners (n = 23). The prevalence of hematopoietic bone marrow hyperplasia was 3% (2/74) for the healthy volunteers, 15% (8/54) for the patients, and 43% (10/23) for the marathon runners. The difference in prevalence between each of the three groups was statistically significant at p less than .05 in each case with hematopoietic bone marrow hyperplasia, the distal femur was the only area affected, while the epiphysis and proximal tibia were uninvolved. This pattern of affected bone marrow with hyperplasia of the hematopoietic marrow may be useful for the differential diagnosis. We postulate that the high prevalence of hematopoietic bone marrow hyperplasia in marathon runners may develop as a response to "sports anemia", which is commonly found in highly conditioned, aerobically trained athletes. Furthermore, this is considered to be a normal variant when found in the pattern described here.
在之前一项针对马拉松运动员的研究中，我们注意到膝关节的磁共振成像（MR）扫描经常显示红骨髓（即造血骨髓）增生。由于该发现在不同人群中的发生率尚不清楚，本研究的目的是确定健康志愿者（n = 74）、有膝关节疾病症状的患者（n = 54）和无症状马拉松运动员（n = 23）膝关节MR检查中造血骨髓增生的相对患病率。健康志愿者中造血骨髓增生的患病率为3%（2/74），患者为15%（8/54），马拉松运动员为43%（10/23）。在每种存在造血骨髓增生的情况下，三组之间患病率的差异均具有统计学意义，p值小于0.05。造血骨髓增生时，仅股骨远端是唯一受影响的区域，而骨骺和胫骨近端未受累。这种造血骨髓增生的受累骨髓模式可能有助于鉴别诊断。我们推测马拉松运动员中造血骨髓增生的高患病率可能是对“运动性贫血”的一种反应，“运动性贫血”在训练有素的有氧运动员中很常见。此外，当在此处描述的模式中发现时，这被认为是一种正常变异。
