Thejeel Bashiar, Lin Ji, Queler Sophie, Nimura Clare, Lin Yenpo, Valle Alejandro Gonzalez Della, Sneag Darryl B
Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70(th) Street, New York, NY 10021, United States of America.
Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70(th) Street, New York, NY 10021, United States of America; Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, No.5, Fuxing Street, Taoyuan 33305, Taiwan.
Clin Imaging. 2024 Apr;108:110112. doi: 10.1016/j.clinimag.2024.110112. Epub 2024 Mar 2.
To illustrate MRI findings in patients with femoral neuropathy following anterior approach total hip arthroplasty (THA).
This was a retrospective review of patients who underwent MRI for femoral neuropathy following anterior approach THA between January 1, 2010, and July 1, 2022. Included patients had no preexisting neurologic condition. Clinical and diagnostic data were collected. MRIs were reviewed in consensus by 2 musculoskeletal radiologists.
A total of 115 patient records were reviewed, 17 of which were included in the final analysis (mean age 64 years; 11 females). Study subjects presented with weakness with hip flexion and knee extension and pain and numbness in the femoral nerve distribution. In 7 subjects, the femoral nerve appeared normal. In 5 subjects, the femoral nerve was hyperintense on fluid-sensitive fat-suppressed imaging. In 4 patients, mass effect on the femoral nerve by either ill-defined soft tissue edema (n = 2), seroma (n = 1), or heterotopic ossification (n = 1) was detected. Only 1 patient had a nerve transection. Patients were imaged at a median time of 8 months (range: 1 day to 11 years) following arthroplasty placement. Clinical follow-up was available in 8 patients, of whom half had complete symptomatic resolution and half had partial improvement at a mean follow-up time of 39.3 months (SD 51.1). Of these 8, 1 underwent revision arthroplasty, 1 had removal of hardware, and another had excision of heterotopic ossification.
MRI provides a means to directly evaluate the femoral nerve following anterior approach THA in both the immediate and chronic postoperative periods.
阐述前路全髋关节置换术（THA）后股神经病变患者的MRI表现。
这是一项对2010年1月1日至2022年7月1日期间因股神经病变接受MRI检查的前路THA患者的回顾性研究。纳入患者术前无神经疾病史。收集临床和诊断数据。由2名肌肉骨骼放射科医生共同对MRI进行评估。
共审查了115份患者记录，其中17份纳入最终分析（平均年龄64岁；11名女性）。研究对象表现为髋关节屈曲和膝关节伸展无力，以及股神经分布区域的疼痛和麻木。7名受试者的股神经外观正常。5名受试者在液体敏感脂肪抑制成像上股神经呈高信号。4名患者检测到股神经受到不明确的软组织水肿（n = 2）、血清肿（n = 1）或异位骨化（n = 1）的占位效应。只有1名患者发生神经横断。患者在关节置换术后的中位时间为8个月（范围：1天至11年）进行成像。8名患者有临床随访资料，其中一半在平均39.3个月（标准差51.1）的随访时间内症状完全缓解，另一半部分改善。这8名患者中，1例行翻修关节置换术，1例取出内固定物，另1例切除异位骨化。
MRI提供了一种在术后即刻和慢性期直接评估前路THA后股神经的方法。
