Laorr A, Greenspan A, Anderson M W, Moehring H D, McKinley T
Department of Radiology, University of California, Davis Medical Center, Sacramento 95817, USA.
Skeletal Radiol. 1995 May;24(4):239-45. doi: 10.1007/BF00198406.
Objective of this study was to present the spectrum of early magnetic resonance imaging (MRI) findings following traumatic dislocation of the femoral head, and to identify any associated injuries that may have therapeutic or prognostic significance and be better delineated by MRI than by conventional radiography.
Prospective MRI of both hips was formed on 18 patients (14 male, 4 female; age range 14-54 years; average age 30.5 years) within 5 weeks of a traumatic femoral head dislocation. The interval between the time of injury and the time of injury and the imaging studies ranged from 2 to 35 days (average 13.2 days). Posterior dislocation was present in 14 patients and anterior dislocation in 4 patients. In the majority of cases, we performed axial T1, coronal T1, and coronal T2* (MPGR) sequences. Images were retrospectively evaluated by consensus of three radiologists for possible abnormalities of the bone and cartilage, joint space, and soft tissues. Because all patients were treated with closed reduction, surgical correlation was not obtained.
All patients had a joint effusion or hemarthrosis. Of the 14 patients with posterior dislocation, isolated femoral head contusions (trabecular microfractures) were identified in 6 patients. Four patients had small femoral head fractures, and one had an osteochondral defect. Acetabular lip fractures were seen in six patients, and one patient had a labral tear. Four patients had intra-articular loose bodies and one had ligamentum teres entrapment. Twelve patients had iliofemoral ligament injury. All patients had muscle injury involving the gluteal region and medical fascial compartment, and 13 patients had anterior fascial compartment muscle injury. Seven patients with posterior dislocation had posterior fascial compartment injury. Of the four patients with anterior dislocation, two had bony contusion, two had cortical infraction, one had a labral tear, and all four had an iliofemoral ligament injury. All four patients in this group had muscle injury of the gluteal region and of the anterior and medial fascial compartments.
MRI can effectively identify and quantify the muscle injury and joint effusion that invariably accompany traumatic hip dislocations. It is also useful for demonstrating trabecular bone contusion (trabecular injury) and iliofemoral ligament injury, which occur commonly with acute hip dislocation.
本研究的目的是呈现股骨头创伤性脱位后的早期磁共振成像（MRI）表现谱，并识别任何可能具有治疗或预后意义且MRI比传统X线摄影能更好显示的相关损伤。
对18例患者（14例男性，4例女性；年龄范围14 - 54岁；平均年龄30.5岁）在股骨头创伤性脱位后5周内进行双髋的前瞻性MRI检查。受伤时间与成像检查的间隔时间为2至35天（平均13.2天）。14例为后脱位，4例为前脱位。在大多数病例中，我们进行了轴位T1、冠状位T1和冠状位T2*（MPGR）序列检查。由三位放射科医生共同对图像进行回顾性评估，以确定骨与软骨、关节间隙及软组织的可能异常情况。由于所有患者均接受了闭合复位治疗，因此未获得手术相关性资料。
所有患者均有关节积液或关节积血。在14例后脱位患者中，6例发现孤立的股骨头挫伤（小梁微骨折）。4例有小的股骨头骨折，1例有骨软骨缺损。6例可见髋臼唇骨折，1例有盂唇撕裂。4例有关节内游离体，1例有圆韧带嵌顿。12例有髂股韧带损伤。所有患者均有涉及臀区和内侧筋膜间隙的肌肉损伤，13例有前侧筋膜间隙肌肉损伤。7例后脱位患者有后侧筋膜间隙损伤。在4例前脱位患者中，2例有骨挫伤，2例有皮质骨折，1例有盂唇撕裂，且所有4例均有髂股韧带损伤。该组所有4例患者均有臀区以及前侧和内侧筋膜间隙的肌肉损伤。
MRI能有效识别和量化创伤性髋关节脱位必然伴随的肌肉损伤和关节积液。它对于显示小梁骨挫伤（小梁损伤）和髂股韧带损伤也很有用，这些损伤在急性髋关节脱位时很常见。
