Albtoush Omar M, Bani-Issa Jafar, Zitzelsberger Tanja, Springer Fabian
Radiology, University of Jordan, Amman, Jordan.
Radiology, King-Hussein-Cancer-Center, Amman, Jordan.
Rofo. 2020 May;192(5):431-440. doi: 10.1055/a-1082-1598. Epub 2020 Feb 27.
Avulsion injuries of the pelvis and hip region are typical injuries in adolescent athletes but can be found in adults as well. Typical sites for avulsion injuries include the origin/insertion of tendons and ligaments. Among adolescents, the not yet ossified apophysis is also frequently involved. The pelvis and hip are especially prone to such injuries due to their complex musculotendinous anatomy. Clinical history and physical examination in combination with the recognition of typical imaging findings are essential for correct diagnosis of these mostly acute, but sometimes also chronic injuries.
This review article describes typical avulsion injuries of the pelvis and hip and illustrates common radiological findings. Taking current literature into account, there is a special focus on the trauma mechanism, clinical examination, typical imaging findings and clinical management.
Detailed knowledge of musculotendinous anatomy and typical injury mechanisms allows a correct diagnosis of avulsion injuries often only based on clinical examination and radiographic findings. Further imaging with ultrasound and MRI may be necessary to evaluate tendon retraction in non-osseous avulsion injuries and extent of soft-tissue damage. Knowledge of potential complications of acute/chronic injuries can help to avoid unnecessary examinations or invasive interventions. Conservative management of avulsion injuries usually leads to functionally good results. However, in the case of competitive athletes, relatively wide bone fragment dislocation or marked tendon retraction, operative re-fixation may be considered in order to expedite the rehabilitation process.
· Avulsion injuries are common injuries at the pelvic region especially in adolescent athletes, due to not yet ossified apophysis.. · Excellent anatomical knowledge is essential for proper diagnostic evaluation and predicting the mechanism of injury.. · Imaging plays a crucial role in diagnosing avulsion injuries starting from X-Ray and using MRI and CT for anatomical details by utilizing multiplanar capabilities..
· Albtoush OM, Bani-Issa J, Zitzelsberger T et al. Avulsion Injuries of the Pelvis and Hip. Fortschr Röntgenstr 2020; 192: 431 - 440.
骨盆和髋部撕脱伤是青少年运动员的典型损伤，但在成年人中也可发生。撕脱伤的典型部位包括肌腱和韧带的起止点。在青少年中，未骨化的骨骺也常受累。由于骨盆和髋部复杂的肌肉肌腱解剖结构，它们特别容易发生此类损伤。临床病史、体格检查以及对典型影像学表现的识别对于正确诊断这些大多为急性但有时也为慢性的损伤至关重要。
这篇综述文章描述了骨盆和髋部的典型撕脱伤，并阐述了常见的放射学表现。考虑到当前的文献，特别关注了创伤机制、临床检查、典型影像学表现和临床管理。
对肌肉肌腱解剖结构和典型损伤机制的详细了解通常仅基于临床检查和影像学表现就能正确诊断撕脱伤。对于非骨性撕脱伤中的肌腱回缩和软组织损伤程度的评估，可能需要进一步进行超声和MRI检查。了解急/慢性损伤的潜在并发症有助于避免不必要的检查或侵入性干预。撕脱伤的保守治疗通常会带来良好的功能结果。然而，对于竞技运动员，如果骨碎片脱位较宽或肌腱回缩明显，可考虑手术重新固定以加速康复进程。
· 撕脱伤是骨盆区域的常见损伤，尤其在青少年运动员中，因为骨骺尚未骨化。· 出色的解剖学知识对于正确的诊断评估和预测损伤机制至关重要。· 影像学在诊断撕脱伤中起着关键作用，从X线开始，利用MRI和CT的多平面成像能力获取解剖细节。
· Albtoush OM, Bani-Issa J, Zitzelsberger T等。骨盆和髋部撕脱伤。Fortschr Röntgenstr 2020; 192: 431 - 440。
