Duncan J B, Hunter R, Purnell M, Freeman J
Aspen Valley Hospital, Colo, USA.
J South Orthop Assoc. 1996 Spring;5(1):13-9.
This study was done to evaluate the magnetic resonance imaging (MRI) findings in acute traumatic effusions of the knee without ligament instability or radiographic abnormality other than the effusion. On reviewing the charts of 927 patients who had MRI of the knee, we found 114 patients who met the following criteria for inclusion in this study: (1) acute effusion by examination or history, (2) ligament stability on examination, and (3) normal findings on radiographs (excluding effusion). The total of 144 pathologic diagnoses made by MRI included bone injury (53%), disruption of the anterior cruciate ligament (19%), sprain of the medial collateral ligament (12%), medial meniscus tear (11%), lateral meniscus tear (5%), and rupture of the posterior cruciate ligament ( < 1%). Eight studies (7%) were read as normal. These MRI data are significantly different from data of previous studies using arthroscopy to evaluate acute knee injuries without ligament instability. The findings more accurately reflect the injury pattern seen in this setting because MRI can show both bone and soft tissue injury. From this study, we conclude that bone injury is the most common cause of acute effusion in the patient with ligament stability and normal radiographs.
本研究旨在评估膝关节急性创伤性积液的磁共振成像（MRI）表现，这些积液患者不存在韧带不稳定情况，且除积液外X线片无异常表现。在查阅927例行膝关节MRI检查患者的病历资料时，我们发现114例患者符合本研究纳入标准：（1）经检查或病史提示有急性积液；（2）检查时韧带稳定；（3）X线片检查结果正常（不包括积液）。MRI做出的144例病理诊断包括骨损伤（53%）、前交叉韧带断裂（19%）、内侧副韧带扭伤（12%）、内侧半月板撕裂（11%）、外侧半月板撕裂（5%）以及后交叉韧带断裂（<1%）。八项研究（7%）结果显示正常。这些MRI数据与以往使用关节镜评估无韧带不稳定的急性膝关节损伤的研究数据存在显著差异。这些发现更准确地反映了这种情况下的损伤模式，因为MRI既能显示骨损伤也能显示软组织损伤。从本研究中，我们得出结论，在韧带稳定且X线片正常的患者中，骨损伤是急性积液最常见的原因。
