Cheokbareun Rehabilitation Clinic, Pohang-si, Gyeonsangbuk-do, Republic of Korea.
Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
Medicine (Baltimore). 2023 Sep 15;102(37):e35270. doi: 10.1097/MD.0000000000035270.
Lesions caused by traffic accidents are often microscopic and minimal; therefore, their diagnosis can be easily overlooked. Moreover, when it is a rarely reported type of lesion, it can be even more easily undiagnosed. Isolated popliteal injuries are uncommon and have rarely been reported.
In this case study, we describe a right partially isolated popliteus tendon rupture that was undiagnosed for 2 years in a patient with posterior knee pain after an in-car traffic accident. A 49-year-old female patient presented with right knee pain that had persisted for 2 years and was initiated after an in-car traffic accident. The patient's right knee pain aggravated while standing and walking. Six months after the accident, her pain was confined to the posterolateral aspect of the knee and subsequently spread throughout her right knee. The pain score was 4 on a numerical rating scale. Physical examination revealed tenderness in the posterolateral corner of the right knee. Additionally, right knee pain was reported in the terminal range of knee flexion during the passive range of motion test. Radiographs of the right knee showed normal findings.
A T2-weighted proton density sagittal and coronal knee magnetic resonance imaging revealed a partial-thickness tear with intrasubstance ganglion cysts at the musculotendinous junction of the popliteus tendon. No other abnormalities were observed in the patient.
Conservative treatment involved strengthening exercises and functional rehabilitation programs.
Six months later, the knee pain almost completely subsided.
Musculoskeletal injuries caused by traffic accidents are frequently overlooked. Therefore, a detailed examination should be conducted for an accurate diagnosis. Clinicians should consider the possibility of popliteal tendon injuries in patients with posterior knee pain.
交通事故引起的损伤常常是微小和轻微的，因此容易被误诊。而且，当损伤类型罕见时，更易被漏诊。孤立的腘绳肌损伤不常见，鲜有报道。
本病例报告中，我们描述了一名 49 岁女性患者，在汽车事故后出现膝后疼痛，2 年内被漏诊右部分孤立的腘绳肌腱断裂。患者 2 年前因汽车事故后出现右膝疼痛，持续至今。患者站立和行走时右膝疼痛加重，6 个月后疼痛局限于膝后外侧，随后蔓延至整个右膝。疼痛评分为 4 分（数字评分量表）。体格检查发现右膝后外侧压痛。此外，在被动活动测试中，右膝关节终末屈曲时有膝痛。右膝关节 X 线片未见明显异常。
磁共振成像（MRI）：T2 加权质子密度矢状位和冠状位膝关节 MRI 显示，腘绳肌腱肌-腱交界处存在部分厚度撕裂，伴有内体神经节囊肿。患者无其他异常。
考虑为右部分孤立的腘绳肌腱断裂。
予保守治疗，包括强化锻炼和功能康复方案。
6 个月后，患者膝痛基本完全缓解。
交通事故引起的肌肉骨骼损伤常常被忽视。因此，详细的体格检查对于准确诊断至关重要。临床医生应考虑到有膝后痛的患者存在腘绳肌腱损伤的可能性。
Zotero 插件