Kim Jin Kyem, Kim Taeho, Lee Hong Seon, Kim Dong Kyu
Department of Radiology, The Armed Forces Capital Hospital, Seongnam, Korea.
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.
Korean J Pain. 2023 Apr 1;36(2):208-215. doi: 10.3344/kjp.22399. Epub 2023 Feb 28.
To evaluate the feasibility, inter-reader reliability, and intra-reader reliability for various morphological features reported to be related to iliotibial band friction syndrome (ITBFS) on knee magnetic resonance imaging (MRI).
A total of 145 patients with a clinical diagnosis and knee MRI findings consistent with ITBFS were included in the "study group" and 232 patients without knee pathology on both physical examination and MRI were included in the "control group". Various morphologic features on knee MRI were assessed including the patella shape, patella height, lateral epicondyle anterior-posterior (AP) width, lateral epicondyle height, ITB diameter (ITB-d), and ITB area (ITB-a).
Patients in the study group had significantly higher lateral epicondyle height (13.9 mm 12.92 mm, = 0.003), ITB-d (2.9 mm 2.0 mm, = 0.022), and ITB-a (38.5 mm 23.8 mm, < 0.001) than the control group. ITB-a showed higher area under the curve index (0.849 with 74.1% sensitivity and 72.4% specificity at a 30.3 mm cutoff) than ITB-d (0.710 with 70.8% sensitivity and 61.2% specificity at 2.4 mm cutoff) and lateral epicondyle height (0.776 with 72.4% sensitivity and 67.8% specificity at 13.4 mm cutoff). However, only the interreader agreement for ITB-a (intraclass correlation coefficient = 0.65) was moderate, while the agreements for other morphologic features were good or excellent.
Lateral epicondyle height seems to be a reliable and feasible morphologic feature for diagnosis of ITBFS.
评估膝关节磁共振成像（MRI）上报告的与髂胫束摩擦综合征（ITBFS）相关的各种形态学特征的可行性、阅片者间可靠性和阅片者内可靠性。
“研究组”纳入145例临床诊断及膝关节MRI表现符合ITBFS的患者，“对照组”纳入232例体格检查和MRI均无膝关节病变的患者。评估膝关节MRI上的各种形态学特征，包括髌骨形状、髌骨高度、外侧髁前后径（AP）、外侧髁高度、髂胫束直径（ITB-d）和髂胫束面积（ITB-a）。
研究组患者的外侧髁高度（13.9 mm比12.92 mm，P = 0.003）、ITB-d（2.9 mm比2.0 mm，P = 0.022）和ITB-a（38.5 mm比23.8 mm，P < 0.001）显著高于对照组。与ITB-d（在2.4 mm截断值时曲线下面积指数为0.710，敏感性为70.8%，特异性为61.2%）和外侧髁高度（在13.4 mm截断值时曲线下面积指数为0.776，敏感性为72.4%，特异性为67.8%）相比，ITB-a显示出更高的曲线下面积指数（在30.3 mm截断值时为0.849，敏感性为74.1%，特异性为72.4%）。然而，只有ITB-a的阅片者间一致性为中等（组内相关系数 = 0.65），而其他形态学特征的一致性为良好或优秀。
外侧髁高度似乎是诊断ITBFS的可靠且可行的形态学特征。
