Radiology Department, Hôpital Sainte-Marguerite, Marseille, France.
Skeletal Radiol. 2010 Sep;39(9):931-3. doi: 10.1007/s00256-010-0929-x. Epub 2010 May 2.
A traumatic fat effusion in a tendon sheath is an unreported entity. We report on the clinical and imaging features, including radiography and computed tomography (CT), of a fat-density effusion in the wrist joint and tendon sheaths of the extensor pollicis longus, extensor carpi radialis longus, and extensor carpi radialis brevis in a 28-year-old patient after a roller-skating accident. Radiographs showed a fracture of the distal radius and a wrist joint effusion. Preoperative CT examination exhibited two distinct layers resulting in a fat-fluid level pathognomonic of lipohemarthrosis in the radiocarpal joint. In addition, a fat-density effusion was noted in the sheaths of the second and third compartment extensor tendons. The lipohemarthrosis depicted on imaging classically results from the extrusion of fat from bone marrow into the joint space after an intraarticular fracture. Similarly, a traumatic fat effusion in a tendon sheath presents characteristic imaging features that may help to diagnose a potentially overlooked fracture.
外伤性腱鞘脂肪积液是一种尚未报道的疾病。我们报告了一例 28 岁患者在轮滑事故后的临床表现和影像学特征，包括腕关节和伸拇长肌腱、伸腕长肌和伸腕短肌腱鞘的脂肪密度积液。X 线片显示桡骨远端骨折和腕关节积液。术前 CT 检查显示两个不同的层面，导致典型的月骨桡腕关节脂肪-血液关节积血。此外，还注意到第二和第三伸肌肌腱鞘内有脂肪密度积液。影像学上显示的脂肪-血液关节积血通常是由于关节内骨折后骨髓内的脂肪挤出到关节间隙所致。同样，肌腱鞘内的外伤性脂肪积液具有特征性的影像学特征，有助于诊断可能被忽视的骨折。
