Hudek Robert, Schmutz Silvia, Regenfelder Felix, Fuchs Bruno, Koch Peter P
Orthopaedic University Hospital Balgrist, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.
Clin Orthop Relat Res. 2009 Aug;467(8):2066-72. doi: 10.1007/s11999-009-0711-3. Epub 2009 Feb 4.
The posterior inclination of the tibial plateau, which is referred to as posterior tibial slope, is determined routinely on lateral radiographs. However, radiographically, it is not always possible to reliably recognize the lateral plateau, making a separate assessment of the medial and lateral plateaus difficult. We propose a technique to measure the plateaus separately by defining a tibial longitudinal axis on a conventional MRI. The medial plateau posterior tibial slope obtained from radiographs was compared with MR images in 100 consecutive patients with knee pain when ligament or meniscal injury was assumed. The posterior tibial slope on MRI correlated with those on radiographs. The mean posterior tibial slope was 3.4 degrees smaller on MRI compared with radiographs (4.8 degrees +/- 2.4 degrees versus 8.2 degrees +/- 2.8 degrees , respectively). The reproducibility was slightly better on radiographs than MRI (+/- 0.9 degrees versus +/- 1.4 degrees ). Twenty-one of the 100 cases had more than a 5 degrees difference (range, -8.7 degrees to 8.9 degrees ) between the medial and lateral plateaus. The proposed technique allows measurement of the posterior tibial slope of the medial and lateral plateaus on a standard knee MRI. By using this novel measurement technique, a reliable assessment of the medial and lateral tibial plateaus is possible.
Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
胫骨平台的后倾角,即胫骨后倾坡度,通常在侧位X线片上测定。然而,在X线片上,并非总能可靠地识别外侧平台,因此难以分别评估内侧和外侧平台。我们提出一种通过在传统磁共振成像(MRI)上定义胫骨纵轴来分别测量平台的技术。在100例连续的疑似韧带或半月板损伤的膝关节疼痛患者中,将X线片上获得的内侧平台胫骨后倾坡度与磁共振图像进行比较。MRI上的胫骨后倾坡度与X线片上的相关。与X线片相比,MRI上的平均胫骨后倾坡度小3.4度(分别为4.8度±2.4度和8.2度±2.8度)。X线片上的可重复性略优于MRI(±0.9度对±1.4度)。100例病例中有21例内侧和外侧平台之间的差异超过5度(范围为-8.7度至8.9度)。所提出的技术允许在标准膝关节MRI上测量内侧和外侧平台的胫骨后倾坡度。通过使用这种新颖的测量技术,可以对内侧和外侧胫骨平台进行可靠的评估。
III级,诊断性研究。有关证据水平的完整描述,请参阅作者指南。