Berger Nicole, Andreisek Gustav, Karer Anissja T, Bouaicha Samy, Naraghi Ali, Manoliu Andrei, Seifert Burkhardt, Ulbrich Erika J
Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Ramistrasse 100, CH - 8091, Zurich, Switzerland.
Department of Forensic Medicine and Radiology, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland.
Eur Radiol. 2017 Jan;27(1):393-403. doi: 10.1007/s00330-016-4339-x. Epub 2016 Apr 21.
To determine the association between traumatic bone marrow abnormalities, the knee injury mechanism, and associated soft tissue injuries in a larger cohort than those in the published literature.
Retrospective study including 220 patients with traumatic knee injuries. Knee MRIs were evaluated for trauma mechanism, soft tissue injury, and the location of bone marrow abnormalities. The locations of the abnormalities were correlated with trauma mechanisms and soft tissue injuries using the chi-square test with Bonferroni correction.
One hundred and forty-four valgus injuries, 39 pivot shift injuries, 25 lateral patellar dislocations, 8 hyperextensions, and 4 dashboard injuries were included. Valgus and pivot shift injuries showed traumatic bone marrow abnormalities in the posterolateral regions of the tibia. Abnormalities after patellar dislocation were found in the anterolateral and centrolateral femur and patella. Hyperextension injuries were associated with abnormalities in almost all regions, and dashboard injuries were associated with changes in the anterior regions of the tibia and femur.
Our study provides evidence of associations between traumatic bone marrow abnormality patterns and different trauma mechanisms in acute knee injury, and reveals some overlap, especially of the two most common trauma mechanisms (valgus and pivot shift), in a large patient cohort.
• Specific bone marrow oedema patterns after knee trauma were confirmed. • New associations between bone marrow oedema patterns and knee trauma were shown. • Bone marrow oedema patterns help in identifying associated soft tissue injuries.
在比已发表文献中更大的队列中，确定创伤性骨髓异常、膝关节损伤机制与相关软组织损伤之间的关联。
对220例创伤性膝关节损伤患者进行回顾性研究。对膝关节磁共振成像（MRI）评估损伤机制、软组织损伤及骨髓异常的位置。采用经Bonferroni校正的卡方检验，将异常位置与损伤机制和软组织损伤进行相关性分析。
纳入144例外翻损伤、39例轴移损伤、25例髌骨外侧脱位、8例膝关节过伸损伤和4例仪表板损伤。外翻和轴移损伤在胫骨后外侧区域显示创伤性骨髓异常。髌骨脱位后，异常出现在股骨前外侧和中央外侧以及髌骨。膝关节过伸损伤几乎与所有区域的异常相关，仪表板损伤与胫骨和股骨前部的改变相关。
我们的研究提供了急性膝关节损伤中创伤性骨髓异常模式与不同损伤机制之间存在关联的证据，并在一个大型患者队列中揭示了一些重叠情况，尤其是两种最常见的损伤机制（外翻和轴移）。
• 证实了膝关节创伤后特定的骨髓水肿模式。• 显示了骨髓水肿模式与膝关节创伤之间的新关联。• 骨髓水肿模式有助于识别相关的软组织损伤。
