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马蹄内翻足:先天性足内翻。

Clubfoot: Congenital Talipes Equinovarus.

机构信息

From the Division of Musculoskeletal Radiology, Department of Diagnostic Imaging (A.d.A.e.C., J.B.P., L.K.M., M.C.A., T.L.M., V.N.S., A.Y.A.), and Discipline of Pediatric Orthopedics, Department of Orthopedics and Traumatology (U.P.R., J.A.P.), Napoleão de Barros St, 800-Vila Clementino, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, SP, Brazil 04024-002; Hospital Israelita Albert Einstein, São Paulo, Brazil (A.d.A.e.C.); Department of Diagnostic Imaging, DASA/Laboratório Delboni Auriemo, São Paulo, SP, Brazil (T.L.M., V.N.S., A.Y.A.); Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil (V.N.S.); and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX (A.K.T.).

出版信息

Radiographics. 2024 Jul;44(7):e230178. doi: 10.1148/rg.230178.

Abstract

Congenital talipes equinovarus (CTEV), also known as clubfoot, is a common musculoskeletal entity that affects one to two per 1000 live births worldwide. Imaging modalities including radiography, US, and MRI have emerged as valuable tools for the diagnosis, treatment, and monitoring of CTEV. The deformity is characterized by midfoot cavus, forefoot adductus, and hindfoot varus and equinus. The Ponseti method of manipulation and serial casting is the standard treatment of CTEV. Radiography shows the anatomy, position, and relationships of the different bones of the foot. US allows accurate assessment of cartilaginous and bony structures, in addition to its inherent advantages such as absence of ionizing radiation exposure. One of the indications for US is to monitor the response to Ponseti method treatment. MRI enables visualization of bones, cartilage, and soft tissues and allows multiplanar evaluation of deformities, providing a comprehensive imaging analysis of CTEV. An integrated approach that combines clinical examination and imaging findings is essential for effective management of CTEV. The authors provide a comprehensive overview of CTEV with a review of imaging modalities to help evaluate CTEV, focusing on radiography, US, and MRI. Using this article as a guide, radiologists involved in the assessment and treatment of CTEV can contribute to the management of the condition. RSNA, 2024 Supplemental material is available for this article.

摘要

先天性马蹄内翻足(CTEV),也称为马蹄足,是一种常见的肌肉骨骼疾病,全球每 1000 例活产中就有 1 至 2 例。影像学检查方法包括放射摄影、超声和 MRI 已经成为 CTEV 的诊断、治疗和监测的有价值的工具。这种畸形的特征是中足内翻、前足内收和后足内翻和下垂。手法复位和系列石膏固定是 CTEV 的标准治疗方法。放射摄影显示了足部不同骨骼的解剖结构、位置和关系。超声除了具有无电离辐射暴露等固有优势外,还可以准确评估软骨和骨结构。超声检查的一个适应证是监测对潘塞提治疗方法的反应。MRI 能够可视化骨骼、软骨和软组织,并允许对畸形进行多平面评估,为 CTEV 提供全面的影像学分析。结合临床检查和影像学表现的综合方法对于 CTEV 的有效管理至关重要。作者全面概述了 CTEV,并回顾了影像学检查方法,以帮助评估 CTEV,重点介绍了放射摄影、超声和 MRI。使用本文作为指南,参与 CTEV 评估和治疗的放射科医生可以为该疾病的管理做出贡献。RSNA,2024 补充材料可在此文章中找到。

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