Rocha de Faria José Leonardo, Crespo Bernardo, Guesser Matheus Weihermann, da Silva Araújo João Henrique, Feitosa Bezerra Pedro Ênio, Menegassi Zartur José Barcelos, de Souza Sergio Augusto Lopes, Pereira Hélcio Mendonça, Mozella Alan de Paula, LaPrade Robert F, Guimarães João Antônio Matheus
National Institute of Traumatology and Orthopedics of Brazil, Rio de Janeiro - RJ, Brazil.
School of Medicine from University of São Paulo - USP Riberão Preto - SP, Brazil.
Arthrosc Tech. 2024 May 14;13(7):103009. doi: 10.1016/j.eats.2024.103009. eCollection 2024 Jul.
Physical examination of knee ligament injuries often is considered subjective and imprecise as the result of various factors affecting its reliability. Magnetic resonance imaging is widely used but lacks information on ligament function and is costly. Stress radiography is commonly employed, but alternatives are sought because of radiation exposure and the need for a physician's presence during the procedure. Ultrasonography represents a noninvasive, rapid, and cost-effective method for assessing knee injuries. This Technical Note presents stress ultrasonography protocols for evaluating medial and lateral tibiofemoral openings in patients with posteromedial corner and/or posterolateral corner injuries. The ultrasonography examination parameters are detailed for both the medial collateral ligament and lateral collateral ligament evaluation. Studies have associated certain degrees of tibiofemoral opening with knee ligament injuries, aiding surgeons in surgical decision-making. Examination with stress ultrasonography offers a dynamic and reproducible method without adverse effects for patients, potentially expediting the diagnosis and treatment of multiligament knee injuries.
由于多种因素影响其可靠性,膝关节韧带损伤的体格检查常被认为主观且不精确。磁共振成像被广泛使用,但缺乏关于韧带功能的信息且成本高昂。应力放射照相术常用,但由于辐射暴露以及检查过程中需要医生在场,人们正在寻找替代方法。超声检查是一种评估膝关节损伤的无创、快速且经济高效的方法。本技术说明介绍了用于评估后内侧角和/或后外侧角损伤患者胫股关节内侧和外侧开口的应力超声检查方案。详细介绍了评估内侧副韧带和外侧副韧带时的超声检查参数。研究已将一定程度的胫股关节开口与膝关节韧带损伤相关联,有助于外科医生进行手术决策。应力超声检查为患者提供了一种动态且可重复的方法,且无不良影响,有可能加快多韧带膝关节损伤的诊断和治疗。