Perera Meeghage Randika, Su Pan, Holdsworth Samantha, Handsfield Geoffrey
Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.
Siemens Medical Solutions, USA, Inc., Malvern, PA, USA.
BMC Musculoskelet Disord. 2025 Jan 9;26(1):34. doi: 10.1186/s12891-024-08254-8.
Ankle sprains often result in muscle atrophy and reduced range of motion, which can cause long-term ankle instabilities. Understanding the changes to muscle-such as atrophy-and concomitant changes to deep fascia-which may thicken alongside muscle loss-after ankle sprain injury is important to understanding structural changes about the joint and how they might contribute to longer-term impairments. Here, we employ advanced MRI to investigate skeletal muscle and fascial structural changes during the recovery period of one patient undergoing immobilization after ankle sprains.
In this case study, a participant who suffered an ankle sprain underwent initial MRI scans and, after 21 days (18 of which included immobilization), a follow-up MRI. Techniques used included proton density, 3D stack of spirals, and diffusion tensor imaging to analyse muscle and fascia changes pre- and post-injury.
Results showed muscle atrophy in most shank muscles, with volume loss ranging from no change in the lateral gastrocnemius to 12.11% in the popliteus. Thigh muscles displayed hypertrophy of 6% in the hamstrings, while the quadriceps atrophied by 2.5%. Additionally, fascia thickness increased from 0.94 mm to 1.03 mm. Diffusion tensor imaging indicated that the biceps femoris experienced the most significant changes in physiological cross-sectional area, while the rectus femoris showed minimal change.
The findings highlight the variable responses of muscles and a notable thickening of deep fascia post-injury, underscoring its role in recovery from ankle sprains.
踝关节扭伤常导致肌肉萎缩和活动范围减小,进而可能引起长期的踝关节不稳定。了解踝关节扭伤后肌肉的变化(如萎缩)以及深筋膜的相应变化(可能会随着肌肉萎缩而增厚),对于理解关节的结构变化以及这些变化如何导致长期功能障碍至关重要。在此,我们采用先进的磁共振成像(MRI)技术,对一名踝关节扭伤后接受制动治疗的患者恢复期的骨骼肌和筋膜结构变化进行研究。
在本病例研究中,一名踝关节扭伤患者先进行了初始MRI扫描,21天后(其中18天为制动期)进行了随访MRI检查。所采用的技术包括质子密度成像、三维螺旋堆叠成像和扩散张量成像,以分析损伤前后肌肉和筋膜的变化。
结果显示,小腿大多数肌肉出现萎缩,萎缩程度从外侧腓肠肌无变化到腘肌萎缩12.11%不等。大腿肌肉中,腘绳肌肥大6%,而股四头肌萎缩2.5%。此外,筋膜厚度从0.94毫米增加到1.03毫米。扩散张量成像表明,股二头肌的生理横截面积变化最为显著,而股直肌变化最小。
研究结果突出了肌肉的不同反应以及损伤后深筋膜的显著增厚,强调了其在踝关节扭伤恢复中的作用。