Compagnoni Riccardo, Lesman Jędrzej, Minoli Carlo, Ferrua Paolo, Mondini Trissino da Lodi Camilla, Domżalski Marcin, Menon Alessandra, Randelli Pietro Simone
U.O.C. 1° Clinica Ortopedica, ASST Gaetano Pini-CTO, Piazza Cardinal Ferrari 1, 20122, Milan, Italy.
Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy.
Knee Surg Sports Traumatol Arthrosc. 2023 Jan;31(1):286-291. doi: 10.1007/s00167-022-07089-x. Epub 2022 Aug 22.
This study aims to find a correlation between bone marrow lesions (BMLs) in knee MRI and pathologies of joint structures. In addition, according to the six-letter system classification, the authors analyzed a potential association between the area affected by BMLs and the specific type of joint lesion.
The authors screened all the knee MRIs performed in the investigation center between 2017 and 2018 to identify the presence of BMLs. The lesions were then categorized following the "six-letter system". The authors searched the presence of associated meniscal, chondral or ligamentous lesions. Finally, the authors researched a correlation between the lesion type described by the six-letter system classification and the associated lesions.
MRI exams of 4000 patients were studied, identifying 666 BMLs. The associated lesions were collected for all patients, resulting in an overall prevalence of related lesions in almost 90% of patients. The authors found a statistical significance for type TLD (Tibia-Lateral-Articular) and ACL rupture. The study suggests a strong positive correlation between type E (Edge) and meniscal fracture or extrusion.
BMLs in the knee are associated in 90% of cases with a radiological sign of related injury to the joint structures. The six-letter system of BMLs type TLD can be considered a sign of ACL rupture and type E as a high suspicious sign for meniscal extrusion. Those very typical BML patterns can help the clinician in the diagnosis of ACL tears and meniscal extrusion. Furthermore, the presence of a BML must be, for the clinician, a high suspicious sign of joint-related injuries.
Level 1.
本研究旨在探寻膝关节磁共振成像（MRI）中的骨髓损伤（BMLs）与关节结构病变之间的相关性。此外，根据六字母系统分类，作者分析了BMLs所累及区域与特定关节病变类型之间的潜在关联。
作者筛查了2017年至2018年在研究中心进行的所有膝关节MRI检查，以确定BMLs的存在情况。然后按照“六字母系统”对病变进行分类。作者查找相关半月板、软骨或韧带损伤的存在情况。最后，作者研究六字母系统分类所描述的病变类型与相关损伤之间的相关性。
对4000例患者的MRI检查进行了研究，共识别出666处BMLs。收集了所有患者的相关损伤情况，几乎90%的患者存在相关损伤的总体患病率。作者发现TLD型（胫骨-外侧-关节）与前交叉韧带（ACL）断裂之间具有统计学意义。该研究表明E型（边缘）与半月板骨折或挤出之间存在强正相关。
膝关节中的BMLs在90%的病例中与关节结构相关损伤的影像学征象相关。BMLs的TLD型六字母系统可被视为ACL断裂的征象，而E型可作为半月板挤出的高度可疑征象。那些非常典型的BML模式可帮助临床医生诊断ACL撕裂和半月板挤出。此外，对于临床医生而言，BMLs的存在必须是关节相关损伤的高度可疑征象。
1级。
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