Zhang Junwei, Lee Chin Hwee
Department of Diagnostic Imaging, National University Hospital, Singapore.
Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Singapore Med J. 2015 Oct;56(10):542-7; quiz 548. doi: 10.11622/smedj.2015149.
A 14-year-old girl presented with left knee pain and swelling after an injury. Magnetic resonance (MR) imaging showed a transient lateral patellar dislocation with patellar osteochondral fracture, medial patellofemoral ligament tear and underlying femoral trochlear dysplasia. Open reduction and internal fixation of the osteochondral fracture, plication of the medial patellar retinaculum and lateral release were performed. As lateral patellar dislocation is often clinically unsuspected, an understanding of its characteristic imaging features is important in making the diagnosis. Knowledge of the various predisposing factors for patellar instability may also influence the choice of surgical management. We also discuss signs of acute injury and chronic instability observed on MR imaging, and the imaging features of anatomical variants that predispose an individual to lateral patellar dislocation. Treatment options and postsurgical imaging appearances are also briefly described.
一名14岁女孩在受伤后出现左膝疼痛和肿胀。磁共振成像显示髌骨外侧一过性脱位,伴有髌骨骨软骨骨折、髌股内侧韧带撕裂及股骨滑车发育不良。对骨软骨骨折进行了切开复位内固定,对髌内侧支持带进行了折叠缝合,并进行了外侧松解。由于髌骨外侧脱位在临床上常难以被怀疑,了解其特征性影像学表现对于诊断很重要。了解髌骨不稳定的各种易感因素也可能影响手术治疗的选择。我们还讨论了磁共振成像上观察到的急性损伤和慢性不稳定的征象,以及易导致个体发生髌骨外侧脱位的解剖变异的影像学特征。还简要描述了治疗选择和术后影像学表现。