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非典型移位半月板撕裂:聚焦于磁共振成像(MRI)和关节镜检查的综述性教育文章

Atypically Displaced Meniscal Tears: An Educational Review with Focus on MRI and Arthroscopy.

作者信息

Spinnato Paolo, Franceschi Paola, Martinese Giuseppe, Parmeggiani Anna, D'Agostino Valerio, Ferraro Silvia, Matcuk George R, Zaffagnini Stefano, Grassi Alberto

机构信息

Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.

Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.

出版信息

Clin Pract. 2025 Jun 12;15(6):109. doi: 10.3390/clinpract15060109.

Abstract

This review article on atypically displaced meniscal tears serves as a critical reminder for radiologists and orthopedic surgeons. It highlights and details uncommon lesions that may be overlooked during MRI evaluation and/or arthroscopic exploration. The knowledge of their existence can enable radiologists to critically assess any meniscal abnormality, keeping in mind its possible arthroscopic presentation. This is essential for assisting the surgeon in making an accurate preoperative diagnosis. In fact, these atypical lesions pose great challenges to surgeons in terms of the technical aspects of their treatment. Often, they could require additional arthroscopic portals for their identification or the need for special devices or instrumentations for the repair. Knowing these challenges in advance is thus imperative for properly planning a proficient surgery. The correct diagnosis and description of tear patterns, including extent and location, allow optimal pre-operative planning with the choice of the indicated approach. Radiologists should know how to recognize menisci tears, even with atypical dislocation patterns. Particularly, in the case of 'minus' detection or thickness reduction in a meniscus, the possible displaced fragment should be carefully searched for, even in atypical sites.

摘要

这篇关于非典型移位半月板撕裂的综述文章对放射科医生和骨科医生来说是一个重要的提醒。它强调并详细介绍了在MRI评估和/或关节镜探查过程中可能被忽视的罕见病变。了解这些病变的存在能够使放射科医生在评估半月板异常时进行严谨判断,同时牢记其可能的关节镜表现。这对于协助外科医生做出准确的术前诊断至关重要。事实上,这些非典型病变在治疗的技术层面给外科医生带来了巨大挑战。通常,识别这些病变可能需要额外的关节镜入路,或者需要特殊的设备或器械来进行修复。因此,提前了解这些挑战对于合理规划一场熟练的手术来说势在必行。对撕裂模式(包括范围和位置)的正确诊断和描述,有助于选择合适的手术方式,从而进行最佳的术前规划。放射科医生应该知道如何识别半月板撕裂,即使是具有非典型移位模式的情况。特别是,在半月板出现“负相”检测或厚度减小时,即使在非典型部位,也应仔细寻找可能移位的碎片。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd88/12192316/7f6eea167999/clinpract-15-00109-g001.jpg

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