Bayer Jörg, Neubauer Jakob, Saueressig Ulrich, Südkamp Norbert Paul, Reising Kilian
Department of Orthopaedics and Trauma Surgery, University Hospital Freiburg, Germany.
Department of Radiology, University Hospital Freiburg, Germany.
Injury. 2016 Apr;47(4):853-8. doi: 10.1016/j.injury.2016.01.039. Epub 2016 Feb 6.
The prevalence of paediatric pelvic injury is low, yet they are often indicative of accompanying injuries, and an instable pelvis at presentation is related to long-term poor outcome. Judging diastasis of the sacroiliac joint in paediatric pelvic computed tomography is challenging, as information on their normal appearance is scarce. We therefore sought to generate age- and gender-related standard width measurements of the sacroiliac joint in children for comparison.
A total of 427 pelvic computed tomography scans in paediatric patients (<18 years old) were retrospectively evaluated. After applying exclusion criteria, 350 scans remained for measurements. Taking a standard approach we measured the sacroiliac joint width bilaterally in axial and coronal planes.
We illustrate age- and gender-related measurements of the sacroiliac joint width as a designated continuous 3rd, 15th, 50th, 85th and 97th centile graph, respectively. Means and standard deviations in the joint width are reported for four age groups. There are distinct changes in the sacroiliac joint's appearance during growth. In general, male children exhibit broader sacroiliac joints than females at the same age, although this difference is significant only in the 11 to 15-year-old age group.
The sacroiliac joint width in children as measured in coronal and axial CT scans differs in association with age and gender. When the sacroiliac joint width is broader than the 97th centile published in our study, we strongly encourage considering a sacroiliac joint injury.
小儿骨盆损伤的发生率较低,但往往提示合并有其他损伤,且就诊时骨盆不稳定与远期不良预后相关。在小儿骨盆计算机断层扫描(CT)中判断骶髂关节分离具有挑战性,因为关于其正常表现的信息较少。因此,我们试图得出儿童骶髂关节与年龄和性别相关的标准宽度测量值以供比较。
对427例18岁以下小儿患者的骨盆CT扫描进行回顾性评估。应用排除标准后,剩余350例扫描用于测量。我们采用标准方法在轴向和冠状面双侧测量骶髂关节宽度。
我们分别以指定的连续第3、15、50、85和97百分位数图表展示了骶髂关节宽度与年龄和性别的测量结果。报告了四个年龄组关节宽度的平均值和标准差。骶髂关节在生长过程中的外观有明显变化。一般来说,同年龄男性儿童的骶髂关节比女性宽,不过这种差异仅在11至15岁年龄组中显著。
在冠状面和轴向CT扫描中测量的儿童骶髂关节宽度随年龄和性别而不同。当骶髂关节宽度比我们研究中公布的第97百分位数宽时,我们强烈建议考虑骶髂关节损伤。