Laor T, Jaramillo D, Hoffer F A, Kasser J R
Department of Radiology, Children's Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
Pediatr Radiol. 1996;26(6):381-7. doi: 10.1007/BF01387310.
Treatment for children with congenital deformities of the lower extremities may vary, depending on the state of the unossified skeletal structures and surrounding soft tissues. The purpose of our study was to demonstrate the spectrum of the osteochondral and extrasosseous abnormalities as depicted with MR imaging. We retrospectively reviewed MR examinations of 13 limbs of ten children (aged 1 month-9 years, mean 2.1 years) with longitudinal and transverse deformities of the lower extremities. The lesions imaged were fibular hemimelia (n = 5), tibial hemimelia (n = 5), and congenital constriction bands (n = 3). Each examination was assessed for abnormalities in the osteocartilaginous and extraosseous (articular or periarticular components such as ligaments, tendons, and menisci; the muscles and the arteries) structures. Abnormalities were seen in all patients. Osteocartilaginous abnormalities in the patients with longitudinal deformities included abnormal distal femoral epiphyses, abnormal proximal tibial physes, hypertrophied and dislocated proximal fibular epiphyses, unsuspected fibular and tibial remnants, and absence or coalition of the tarsal bones. No osteocartilaginous abnormalities were seen in the patients with congenital constriction bands. Articular abnormalities about the knee in patients with either form of hemimelia included absent cruciate ligaments and menisci, dislocated or absent cartilaginous patellae, absent patellar tendons, and abnormal collateral ligaments. All but one limb imaged had absent or attenuated muscle groups. Of the nine MR arteriograms performed at the level of the knee, eight were abnormal. The normal popliteal trifurcation was absent or in an abnormal location. We conclude that MR imaging of children with congenital lower extremity deformities shows many osteochondral and extraosseous abnormalities that are not depicted by conventional radiography. This information can help to plan early surgical intervention and prosthetic rehabilitation.
先天性下肢畸形患儿的治疗方法可能因未骨化骨骼结构及周围软组织的状况而异。我们研究的目的是展示磁共振成像（MR成像）所显示的骨软骨及骨外异常的范围。我们回顾性分析了10名儿童（年龄1个月至9岁，平均2.1岁）13条下肢的纵向和横向畸形的MR检查结果。成像的病变包括腓骨半肢畸形（n = 5）、胫骨半肢畸形（n = 5）和先天性束带（n = 3）。对每次检查的骨软骨和骨外（关节或关节周围结构，如韧带、肌腱和半月板；肌肉和动脉）结构进行异常评估。所有患者均发现异常。纵向畸形患者的骨软骨异常包括股骨远端骨骺异常、胫骨近端骺板异常、腓骨近端骨骺肥大和脱位、未被怀疑的腓骨和胫骨残余，以及跗骨缺如或融合。先天性束带患者未发现骨软骨异常。两种半肢畸形患者膝关节周围的关节异常包括交叉韧带和半月板缺如、软骨髌骨脱位或缺如、髌腱缺如以及侧副韧带异常。除一条成像肢体外，所有肢体均存在肌肉群缺如或减弱。在膝关节水平进行的9次MR血管造影中，8次异常。正常的腘动脉三叉分支缺如或位置异常。我们得出结论，先天性下肢畸形患儿的MR成像显示出许多传统X线摄影未显示的骨软骨和骨外异常。这些信息有助于规划早期手术干预和假体康复。
