Rangger C, Klestil T, Kathrein A, Inderster A, Hamid L
Department of Traumatology, University Hospital of Innsbruck, Austria.
Clin Orthop Relat Res. 1996 Sep(330):133-42. doi: 10.1097/00003086-199609000-00016.
In a prospective study, magnetic resonance imaging was performed before arthroscopy for all patients (n = 121) with a meniscal tear (n = 125). Criteria of the study were stable cruciate and collateral ligaments, absence of pathologic radiographic findings, and absence of prior surgical interventions of the involved knee joint. In 43 knees (34%), the clinical diagnosis of a meniscal tear was discarded because of the results of the magnetic resonance imaging examination. Synovitis was diagnosed in 16 patients (13%), articular cartilage damage in 10 patients (8%), bone bruise injuries in 10 patients (8%), osteochondritis dissecans in 3 patients (2%), disruption of the inner layer of the medial collateral ligament in 3 patients (2%), and osteonecrosis in 1 patient. The use of magnetic resonance imaging in establishing diagnosis of disorders of the knee joint altered treatment in a significant proportion of patients. Magnetic resonance imaging should be done before arthroscopy of the knee in all cases in which the clinical diagnosis has been reduced to a suspected meniscus injury.
在一项前瞻性研究中，对所有半月板撕裂患者（n = 121，半月板撕裂125处）在关节镜检查前进行了磁共振成像。研究标准为交叉韧带和侧副韧带稳定、无影像学病理性表现以及患膝关节无既往手术史。43个膝关节（34%）因磁共振成像检查结果而排除了半月板撕裂的临床诊断。16例患者（13%）诊断为滑膜炎，10例患者（8%）诊断为关节软骨损伤，10例患者（8%）诊断为骨挫伤，3例患者（2%）诊断为剥脱性骨软骨炎，3例患者（2%）诊断为内侧副韧带内层断裂，1例患者诊断为骨坏死。磁共振成像在膝关节疾病诊断中的应用使相当一部分患者的治疗发生了改变。在所有临床诊断已缩小至疑似半月板损伤的病例中，膝关节镜检查前均应进行磁共振成像检查。
