Sharma U K, Dhungel K, Pokhrel D, Tamang S, Parajuli N P
Department of Radiology, B and C Teaching Hospital, Birtamod, Jhapa.
Department of Orthopedics, B and C Teaching Hospital, Birtamod, Jhapa.
Kathmandu Univ Med J (KUMJ). 2018;16(61):28-34.
Background Ankle and foot pain is a common clinical problem, that may be due to a variety of soft tissue and osseus abnormalities. Magnetic resonance imaging plays vital role for diagnosing internal derangement of the ankle joint, assessing soft tissue structures around the ankle such as tendons, ligaments, nerves and osseus structures. Method Retrospective magnetic resonance imaging evaluation of the ankle and foot was done in 100 patients using 0.3T and 1.5T magnetic resonance imaging. Clinical history included pain, swelling of the ankle and foot, trauma, twisting injury, palpable mass and difficulty in walking. Result Fifty two patients were male and 48 patients female aged 6 months to 70 years. Ligaments tear were the commonest and seen in 22% patients. Tenosynovitis found in 17%, Pigmented villonodular synovitis (PVNS) in 3%, Achilles tendon abnormality in 8%, stress fracture-9%, osteomyelitis-8%, soft tissue vascular malformation in 5%, soft tissue and bone tumor-4%, marrow edema-20%, osteoarthritis-10%, Osteochondral lesion of talus-8%, sinus tarsi syndrome-3%, posterior impingement-5%, plantar fasciitis-2%, Sever disease-2%, peroneus tendon split-2%. The commonest clinical presentation was pain and swelling of the ankle in 42 patients, twisting/inversion injury of the ankle in 23 patients followed by traumatic injury with difficulty in walking in 20 patients and palpable mass in 8 patients. Ligaments injury were mostly associated with inversion/twisting injury. Conclusion Magnetic resonance imaging is advantageous for assessing soft tissue structures around the ankle and foot, such as tendons, ligaments, nerves, masses and occult osseus lesions. It provides a quick, non-invasive tool for the diagnosis of related injuries and guide for the further treatment planning.
踝关节和足部疼痛是常见的临床问题，可能由多种软组织和骨骼异常引起。磁共振成像在诊断踝关节内部紊乱、评估踝关节周围的软组织结构（如肌腱、韧带、神经和骨骼结构）方面起着至关重要的作用。
对100例患者进行踝关节和足部的回顾性磁共振成像评估，使用0.3T和1.5T磁共振成像。临床病史包括疼痛、踝关节和足部肿胀、创伤、扭伤、可触及肿块和行走困难。
52例为男性，48例为女性，年龄6个月至70岁。韧带撕裂最为常见，见于22%的患者。腱鞘炎占17%，色素沉着绒毛结节性滑膜炎（PVNS）占3%，跟腱异常占8%，应力性骨折占9%，骨髓炎占8%，软组织血管畸形占5%，软组织和骨肿瘤占4%，骨髓水肿占20%，骨关节炎占10%，距骨骨软骨损伤占8%，跗骨窦综合征占3%，后方撞击占5%，足底筋膜炎占2%，Sever病占2%，腓骨肌腱撕裂占2%。最常见的临床表现是42例患者踝关节疼痛和肿胀，23例患者踝关节扭伤/内翻损伤，其次是20例患者因创伤性损伤导致行走困难，8例患者可触及肿块。韧带损伤大多与内翻/扭伤有关。
磁共振成像有利于评估踝关节和足部周围的软组织结构，如肌腱、韧带、神经、肿块和隐匿性骨病变。它为相关损伤的诊断提供了一种快速、非侵入性的工具，并为进一步的治疗计划提供指导。
