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[膝关节后外侧旋转不稳定的影像学表现]

[Imaging of posterolateral rotational instability of the knee joint].

作者信息

Müller Dirk

机构信息

Zentrales Röntgeninstitut, Muskuloskelettale und Traumabildgebung, Kantonsspital Graubünden, Loëstr. 170, 7000, Chur, Schweiz.

出版信息

Radiologie (Heidelb). 2024 Apr;64(4):271-277. doi: 10.1007/s00117-023-01258-w. Epub 2024 Jan 30.

Abstract

Posterolateral instability of the knee joint typically occurs with injuries to the posterolateral corner of the joint or with additional combined injuries involving the anterior and posterior cruciate ligaments. In addition to numerous, smaller anatomical structures, the most important are the lateral collateral ligament (LCL), the popliteus muscle with its tendon, and the popliteofibular ligament (PFL), which can usually be assessed using magnetic resonance imaging (MRI). On the contrary, small structures like the arcuate ligament and fabellofibular ligament cannot always be identified. However, they are also of lesser importance in the development of posterolateral rotational instability. Overlooked injuries to the posterolateral joint corner promote instability with the complication of inadequate ligament reconstruction and early onset posttraumatic osteoarthritis. Knowledge of MRI morphology of the anatomical structures involved, taking into account their biomechanical significance, is crucial to recognize and use the corresponding imaging findings.

摘要

膝关节后外侧不稳定通常发生于关节后外侧角损伤或合并前、后交叉韧带损伤时。除众多较小的解剖结构外,最重要的是外侧副韧带(LCL)、腘肌及其肌腱以及腘腓韧带(PFL),这些结构通常可通过磁共振成像(MRI)进行评估。相反,像弓状韧带和腓肠豆腓侧韧带等小结构并非总能被识别。然而,它们在发展后外侧旋转不稳定方面的重要性也较低。后外侧关节角损伤若被忽视,会导致不稳定,并伴有韧带重建不足和创伤后骨关节炎早期发作等并发症。了解所涉及解剖结构的MRI形态,并考虑其生物力学意义,对于识别和利用相应的影像学表现至关重要。

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