Choi Sang-Hee, Ji Suk Kyeong, Lee Seung Ah, Park Min Jong, Chang Moon Jong
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Physical Medicine and Rehabilitation, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
PLoS One. 2017 Jun 16;12(6):e0174320. doi: 10.1371/journal.pone.0174320. eCollection 2017.
Magnetic resonance imaging (MRI) may be useful to diagnose a posterolateral plica syndrome of the elbow joint because this syndrome has less clear clinical features. The purposes of this study were to document mediolateral and sagittal dimensions of a posterolateral synovial fold and to determine the proportion of subjects with the posterolateral plica in asymptomatic elbows. We also aimed to determine whether the dimensions of the posterolateral synovial fold and the prevalence of the plica differ between symptomatic and asymptomatic subjects.
This retrospective review of prospectively collected data included 50 asymptomatic elbows (asymptomatic group) and 14 elbows with arthroscopically confirmed posterolateral plicae (plica group). The mediolateral and sagittal dimensions of the posterolateral synovial fold were measured. In addition, the criteria for the prevalence of posterolateral plica was determined with conventional MRI as synovial fold dimension ≥ 3 mm and coverage of radial head by synovial fold ≥ 30%.
The plica group showed larger posterolateral synovial fold dimensions compared to the asymptomatic group. The median mediolateral and sagittal dimensions of the synovial fold in the asymptomatic group were 3.8 mm and 4.7 mm, respectively. Dimensions in the plica group were 7.0 mm and 7.4 mm, respectively. When the presence of posterolateral plica was determined using the dimension criteria, there was no difference in the prevalence of the plica between the asymptomatic and the plica group. However, using the coverage criteria, the prevalence of posterolateral elbow plica was significantly greater in the plica group than the asymptomatic group (64% vs. 18%; p < 0.001).
The patients who underwent arthroscopic surgery for posterolateral plica syndrome had larger dimensions of the posterolateral synovial fold and higher prevalence of the posterolateral plica on conventional MRI compared to the asymptomatic subjects.
磁共振成像（MRI）对于诊断肘关节后外侧滑膜皱襞综合征可能有用，因为该综合征的临床特征不太明显。本研究的目的是记录后外侧滑膜皱襞的内外侧和矢状径，并确定无症状肘关节中存在后外侧皱襞的受试者比例。我们还旨在确定有症状和无症状受试者之间后外侧滑膜皱襞的尺寸以及皱襞的患病率是否存在差异。
本项对前瞻性收集数据的回顾性研究纳入了50个无症状肘关节（无症状组）和14个经关节镜证实存在后外侧皱襞的肘关节（皱襞组）。测量后外侧滑膜皱襞的内外侧和矢状径。此外，传统MRI确定后外侧皱襞患病率的标准为滑膜皱襞尺寸≥3 mm且滑膜皱襞覆盖桡骨头≥30%。
与无症状组相比，皱襞组的后外侧滑膜皱襞尺寸更大。无症状组滑膜皱襞的内外侧径中位数分别为3.8 mm和矢状径为4.7 mm。皱襞组的尺寸分别为7.0 mm和7.4 mm。当使用尺寸标准确定后外侧皱襞的存在时，无症状组和皱襞组之间皱襞的患病率没有差异。然而，使用覆盖标准时，皱襞组肘关节后外侧皱襞的患病率显著高于无症状组（64%对18%；p<0.001）。
与无症状受试者相比，因后外侧皱襞综合征接受关节镜手术的患者在传统MRI上后外侧滑膜皱襞尺寸更大，后外侧皱襞的患病率更高。
