Sanders Timothy G, Rathur Sharik Kabir
National Musculoskeletal Imaging, 1930 N. Commerce Parkway, Suite #5, Weston, FL 33326, USA.
Radiol Clin North Am. 2008 Nov;46(6):1079-92, vii. doi: 10.1016/j.rcl.2008.09.001.
Numerous injuries and pathologic conditions can involve the hallucal sesamoidal complex and plantar capsular structures of the first metatarsophalangeal joint. Although clinical history and presentation are important in developing a reasonable differential diagnosis, there is often considerable overlap in the clinical presentation and physical findings between various pathologic entities. Imaging plays an important role in narrowing the differential diagnosis and in directing appropriate therapy. This article reviews the normal anatomy of the hallucal sesamoidal complex and the plantar capsular structures of the first metatarsophalangeal joint. Typical clinical presentations are discussed for various pathologic entities that involve this area of the hallux, followed by a summary of the various imaging findings that occur when using conventional radiography, nuclear medicine bone scan, CT and MR imaging. Finally, general treatment guidelines are discussed for each entity.
许多损伤和病理状况可累及拇趾籽骨复合体及第一跖趾关节的跖侧关节囊结构。虽然临床病史和表现对于做出合理的鉴别诊断很重要，但各种病理实体的临床表现和体格检查结果往往有相当大的重叠。影像学在缩小鉴别诊断范围和指导适当治疗方面发挥着重要作用。本文回顾了拇趾籽骨复合体及第一跖趾关节跖侧关节囊结构的正常解剖。讨论了累及拇趾该区域的各种病理实体的典型临床表现，随后总结了使用传统X线摄影、核医学骨扫描、CT和磁共振成像时出现的各种影像学表现。最后，讨论了针对每种实体的一般治疗指南。
