【摘要】 目的 探讨胫、股骨髁应力性骨折的影像学表现及其诊断价值。方法 回顾性分析经影像学检查并随访证实且资料齐全的13例胫、股骨内侧髁应力性骨折的影像学表现,其中股骨内侧髁4例、胫骨内侧髁9例。13例患者中7例行膝关节X线平片、CT、MRI平扫检查,1例行膝关节X线平片、MRI平扫检查,2例行膝关节CT、MRI平扫检查,3例行膝关节MRI平扫检查。病例随访时间6～9月。结果 将13例应力性骨折分为疲劳性和衰竭性应力骨折2型,其中疲劳性骨折8例,衰竭性应力骨折5例。骨折线位于胫骨或股骨内侧髁骨骺线附近,骨皮质连续,未见骨质破坏和骨膜反应征象。X线示2例（2/8）胫骨或股骨内侧髁呈水平线状或条状高密度影,6例（6/8）示无异常或骨质疏松,2例（2/8）胫骨或股骨内侧髁邻近软组织稍肿胀。CT示9例胫骨或股骨髁内侧髁不规则的水平线状或条状密度增高影,边界清楚,6例（6/9）示胫骨或股骨内侧髁邻近软组织稍肿胀。MRI示13例（13/13）胫骨或股骨内侧髁大片状长T₁、长T₂信号,内有不规则水平线状或条状长T₁、短T₂信号,边界尚清,胫骨或股骨内侧髁邻近软组织轻度水肿。结论 X线平片显示胫骨或股骨内侧髁应力性骨折敏感性低,CT敏感性较高,MRI敏感性最高,并具有特征性表现,结合病史,M RI可对胫骨或股骨内侧髁应力性骨折作出较准确诊断。更多还原

【Abstract】 Objective To investigate the imaging findings of stress fracture of condyles of the tibia and femur.Methods 13 cases of stress fractures of condyles of the tibia and femur were analyzed retrospectively.The data of the images and follow-up results were collected during the period from 2005 to 2012,in which 4 cases were located in condylus medialis femoris,9 cases in condylus medialis tibia.7 cases were examined by X-ray,CT,as well as MRI,1 case by X-ray and MRI,2 cases by CT and MRI,3 cases by MRI only.All cases were followed up 6-9 monthes.Results There were fatigue fracture（8 cases） and stress fracture（5 cases）.Fracture lines located at condylus medialis femoris or condylus medialis tibiae,and cortical bon was intact,no destruction of the bone or periosteal reaction were founded.On X-ray study,a line or strip high-density was found at condylus,in 2 cases other 7 cases were normal or osteoporosis,and surrounding soft tissues were not founded to be swell.On CT images,irregular line or strip high-density was found,which bouncary was distinct,the soft tissues nearby medial condoyle were slightly swell,and cortical bone was intact.On MRI,an extensive area was found to be long T₁,long T₂ signal intensity at medial condylus,in which an irregularity line or strip long T₁ short T₂ signal was showed,which bouncary was distinct,soft tissues nearby condylus medialis were slightly swell,cortical bone was continuous.Conclusion The sensitivity of diagnosis of stress fracture is low on X-ray,satisfactory on CT and MRI,relative perfect on MRI,therefore,according to clinical history,combined with MRI,the diagnosis was accurate.更多还原