Department of Orthopaedic Surgery, University of Missouri at Columbia, United States.
Department of Radiology, University of Missouri at Columbia, United States.
Eur J Radiol. 2019 Dec;121:108709. doi: 10.1016/j.ejrad.2019.108709. Epub 2019 Oct 17.
To describe the MRI findings of the "Stener-like" lesion of the knee and its distinction from simple medial collateral ligament (MCL) tear. A "Stener-like" lesion of the superficial medial collateral ligament is a tear involving the distal fibers, where the torn fibers become displaced superficial to the pes anserinus fibers, a displacement which can prevent healing.
Nine cases of Stener-like lesion were prospectively diagnosed on MRI. Retrospective, IRB-approved, HIPAA-compliant chart review was performed to determine correlation of surgical and MRI findings. Seven cases were surgically confirmed and are included in the series.
MRI is useful in making the diagnosis of Stener-like lesions and prompting the surgeon to explore the distal MCL. Coronal MRI shows variable proximal retraction of the torn ligament. It has a lax contour and abuts the pes anserinus. The proximity of the torn ligament end to the pes can result in misdiagnosis of a partial tear. Axial images are useful to confirm position of the ligament superficial to the pes. All cases had associated tear of the deep MCL fibers, as well as sprains of the proximal superficial MCL.
It is important to recognize the Stener-like lesion because this lesion is usually managed surgically, while most MCL tears are managed conservatively. The presence of injury to the proximal MCL is usually present, and may be a distractor from the distal injury. Care must be taken to include the distal attachment of the sMCL on coronal MRI images.
描述膝关节“Stener 样”病变的 MRI 表现，并将其与单纯内侧副韧带（MCL）撕裂相区别。浅层内侧副韧带的“Stener 样”病变是一种涉及远端纤维的撕裂，撕裂的纤维在鹅足肌腱纤维的浅层移位，这种移位可能会妨碍愈合。
前瞻性诊断 9 例膝关节“Stener 样”病变。回顾性、IRB 批准、符合 HIPAA 标准的图表审查，以确定手术和 MRI 结果的相关性。7 例经手术证实并包含在该系列中。
MRI 有助于诊断“Stener 样”病变，并促使外科医生探查 MCL 远端。冠状位 MRI 显示撕裂韧带近端有不同程度的回缩。其轮廓松弛，并与鹅足相邻。撕裂韧带末端与鹅足的接近可能导致部分撕裂的误诊。轴向图像有助于确认韧带在鹅足上方的位置。所有病例均伴有深层 MCL 纤维撕裂，以及浅层 MCL 近端扭伤。
认识到“Stener 样”病变很重要，因为这种病变通常需要手术治疗，而大多数 MCL 撕裂则需要保守治疗。MCL 近端损伤通常存在，可能会分散对远端损伤的注意力。在冠状位 MRI 图像上必须注意包括 sMCL 的远端附着点。
