MRI determination of muscle recruitment variations in dynamic ankle plantar flexion exercise

OBJECTIVE: The purpose of this study was to investigate the muscle recruitment variations in the dynamic ankle plantar flexion. DESIGN: A total of 17 subjects participated in this study and performed the ankle plantar flexion exercise. Magnetic resonance T2-weighted images were obtained from the calf before and immediately after exercise to calculate each T2 relaxation time in the medial and lateral gastrocnemius, soleus, tibialis posterior, flexor digitorum/hallucis longus, peroneus longus, and dorsiflexors. RESULTS: All the muscles except the dorsiflexors showed significantly increased T2 relaxation time and signal intensity on T2-weighted images after exercise. Above all, both gastrocnemius muscles showed significantly greater postexercise T2 relaxation time than the soleus, tibialis posterior, flexor digitorum/hallucis longus, and dorsiflexors. In addition, the peroneus longus had a tendency to show the greatest T2 relaxation time next to the gastrocnemius, but there was no significant difference between them. CONCLUSIONS: The present study may suggest that the gastrocnemius muscle, especially the medial side, was best recruited in the dynamic ankle plantar flexion exercise. In addition, it is possible that the peroneus longus was most recruited next to the gastrocnemius in this exercise mode.     

Stenosing tenosynovitis

Tenosynovitis refers to an inflammatory condition involving the synovial sheath of a tendon. Stenosing tenosynovitis is a peculiar entity caused by multiple factors, including local anatomy, mechanical factors, and hormonal factors. The main forms include de Quervain tendinopathy; trigger finger (stenosing tenosynovitis involving the flexor digitorum tendons); stenosing tenosynovitis of the extensor carpi ulnaris, extensor carpi radialis, or extensor comunis tendons; stenosing tenosynovitis of the flexor hallucis tendon; and stenosing tenosynovitis of the peroneal tendons. The cardinal finding on ultrasonography is the presence of a thickened retinaculum or pulley that constricts the osseofibrous tunnel through which the tendon runs.     

Finite element analysis of the foot: Model validation and comparison between two common treatments of the clawed hallux deformity

Background

Clawed hallux is defined by first metatarsophalangeal joint extension and first interphalangeal joint flexion; it can increase plantar pressures and ulceration risk. We investigated two corrective surgical techniques, the modified Jones and flexor hallucis longus tendon transfer.

Methods

A finite element foot model was modified to generate muscle overpulls, including extensor hallucis longus, flexor hallucis longus and peroneus longus. Both corrective procedures were simulated, predicting joint angle and plantar pressure changes.

Findings

The clawed hallux deformity was generated by overpulling: 1) extensor hallucis longus, 2) peroneus longus + extensor hallucis longus, 3) extensor hallucis longus + flexor hallucis longus and 4) all three together. The modified Jones reduced metatarsophalangeal joint angles, but acceptable hallux pressure was found only when there was no flexor hallucis longus overpull. The flexor hallucis longus tendon transfer reduced deformity at the metatarsophalangeal and interphalangeal joints but may extended the hallux due to the unopposed extensor hallucis longus. Additionally, metatarsal head pressure increased with overpulling of the extensor hallucis longus + flexor hallucis longus, and all three muscles together.

Interpretation

The modified Jones was effective in correcting clawed hallux deformity involving extensor hallucis longus overpull without flexor hallucis longus overpull. The flexor hallucis longus tendon transfer was effective in correcting clawed hallux deformity resulting from the combined overpull of both extensor and flexor hallucis longus, but not with isolated extensor hallucis longus overpull. An additional procedure to reduce the metatarsal head pressure may be required concomitant to the flexor hallucis longus tendon transfer. However this procedure avoids interphalangeal joint fusion.     

MR 3D-PD-SPACE序列在评估正常踝关节韧带肌腱中的应用价值

目的：对比分析3D-SPACE序列及常规2D-TSE在对踝关节韧带及肌腱组织的显示价值。材料与方法21例健康自愿者进行3D-PD-SPACE三维各项同性矢状面扫描和2D-T2WI-FSE二维快速自旋回波各方位扫描,分别测量韧带、肌腱、软骨、关节液、肌肉的信噪比（SNR）以及关节液与软骨、脂肪与韧带、肌肉与肌腱的对比信噪比（CNR）。然后由2名资深MR医生对韧带、肌腱、软骨、关节液的显示效果、细节,图像质量（模糊、假象、容积效应、均匀性）等几方面进行评估,并用5分利克特量表（5-point Likert scale）来评估。结果 SPACE序列各组织SNR明显高于2D序列,两者有统计学意义（P〈0.01）;在关节液与软骨、关节液与韧带、关节液与脂肪、肌肉与肌腱CNR上3D高于2D的序列,两者同样有统计学意义（P〈0.01）。图像质量评估方面SPACE序列在距腓前韧带、跟腓韧带、内侧副韧带、纵向跟舟韧带薄层重建上比2D序列有更多优势,两者之间的差异有统计学意义（P〈0.05）;趾长伸肌腱、胟伸肌腱、腓长肌腱、腓短肌腱及趾长屈肌腱SPACE与2D比较薄层重建同样有统计学意义（P〈0.05）。结论3D-PD-SPASE质子加权各项同性踝关节扫描对踝关节韧带和肌腱的评估有重要价值,由于3D有多平面重建和曲面重建等特点能更好地满足临床的需要。     

Carpal tunnel: Normal anatomy,anatomical variants and ultrasound technique

The carpal tunnel is an osteofibrous canal situated in the volar wrist. The boundaries are the carpal bones and the flexor retinaculum. In addition to the medial nerve, the carpal tunnel contains nine tendons: the flexor pollicis longus, the four flexor digitorum superficialis and the four flexor digitorum profundus. Ultrasound (US) study of the carpal tunnel generally involves short-axis imaging of the tendons, and in the presence of disease, long-axis imaging and dynamic maneuvers are added. There are numerous reports of anatomical variants of the wrist involving vessels, nerves, tendons and muscles, and they can all be studied by US. Some are particularly relevant from a clinical point of view and will therefore be accurately described. The anatomy is complex, and the US operator should therefore be thoroughly familiar with the normal anatomy as well as the anatomical variants that may have a role in the pathogenesis of carpal tunnel syndrome or influence treatment.     

101例军事训练致踝关节损伤MRI表现与损伤特点

目的 探讨军事训练踝关节损伤的MRI表现与损伤特点。方法 以2019年就诊于新疆军区总医院北京路医疗区的军事训练踝关节损伤患者为研究对象,问卷调查收集相关资料,行踝关节MRI平扫。检查结果由3名专科医师对韧带、肌腱、骨质等影像表现进行分析并确定损伤情况。依据服役年限随机分为新、老兵组,分析两组踝关节损伤不同程度的特点。结果 101例对象被纳入研究,损伤101侧。韧带损伤：距腓前韧带33侧,距腓后韧带39侧,跟腓韧带5侧,三角韧带7侧,胫舟韧带1侧。肌腱损伤：踇长屈肌腱21侧,胫骨后肌腱18侧,趾长屈肌腱7侧,腓骨长肌腱4侧,腓骨短肌腱1侧,跟腱炎21侧,跟腱滑囊炎5侧。骨质损伤：软骨损伤7侧,骨折6侧,骨髓水肿60侧,脱位1侧。新兵踝关节损伤以骨质损伤与混合损伤两种类型为主。老兵组软组织损伤占比率明显高于新兵组(P<0.05)。结论 军事训练致踝关节损伤MRI表现损伤特点在新老兵中存在显著不同。     

Selection criteria for surgical correction of equinovarus foot in adults with brain damage: A systematic scoping review

ObjectiveTo report on preoperative outcomes that guide the choice of surgical techniques to correct equinovarus foot in adults with brain injury.MethodsFour databases (PubMed, MEDLINE, Cochrane, PEDro) were searched according to the PRISMA guidelines. Studies were included regardless of their level of proof, with no limitation on date of publication, and their quality was assessed with the Methodological Index for Non-Randomized Studies score.ResultsWe analysed 61 studies (n = 2,293 participants); 523 participants underwent neurotomy, 437 calf musculotendinous lengthening, and 888 tibialis anterior transfer or alternative anterior transfers with the flexor digitorum/hallucis longus (n = 249), the extensor hallucis longus (n = 102), the tibialis posterior (n = 41) and the peroneus longus (n = 41). Two studies were dedicated to osteoarticular surgeries (n = 12 participants). Ankle dorsiflexors motricity was assessed before 70% of neurotomies as compared with 29% before isolated calf lengthening studies, their strength being at least 3/5 in 33% and 50% of the studies concerned, respectively. Passive ankle dorsiflexion was assessed before surgery in 87% of neurotomy studies, with 62% of studies investigating non-retracted spastic equinovarus foot. Before anterior tendon transfer with the tibialis anterior or another muscle, passive ankle dorsiflexion was reported in only 20% and 46% of studies, respectively, and dynamic tibialis anterior activation during gait in 46% and 56%. Although voluntary recruitment of the tibialis anterior produced a better functional result, the presence/correction of varus justified its transfer in 60% of studies as compared with 30% in other transfers, which were justified by hyperactivity or voluntary recruitment of transferred muscle.ConclusionsThis review highlights the poor level of preoperative assessment and the absence of formal criteria to indicate the different surgical approaches in the management of equinovarus foot. It reinforces the interest of a systematic standardized preoperative assessment such as selective motor block and dynamic electromyography to choose the most suitable surgical procedure.     

Intramuscular recording of H-reflexes from muscles of the posterior compartment of the lower leg

This study was designed to elucidate the role of different muscles of the posterior compartment of the lower leg in the generation of the surface-recorded H-reflex. H-reflexes were evoked through percutaneous stimulation of the posterior tibial nerve and recorded concurrently, using monopolar electrodes from the soleus (SOL), medial and lateral gastrocnemii (MG and LG), tibialis posterior (TP), flexor digitorum longus (FDL), and flexor hallucis longus (FHL). There were significant (P less than 0.01) differences in the amplitudes, latencies, and modified H:M ratios of the responses recorded from the different muscles. The SOL modified H:M ratios were consistently the highest (x = 1.02), while the H:M ratios for MG (x = 0.34) and LG (x = 0.37) were consistently the lowest. Latencies of H-reflexes obtained from proximal recording sites (x = 29.2 ms) were significantly shorter than those from the most distal site (x = 31.5 ms). These results establish the contribution made by various deep and superficial muscles to the conventionally recorded H-reflex and help explain the differences in H-reflex amplitudes and latencies when recordings are made from different sites.     

Electromyographic insertional activity in normal limb muscles.

A mechanical electrode inserter was used to allow reproducible electromyographic (emg) electrode insertions. The electrical activity provoked by the mechanical insertion was recorded and quantitatively analyzed in the anterior tibialis, the extensor hallucis longus, and the extensor digitorum brevis of unimpaired human subjects. No statistically significant differences were found among these muscles in the total duration of sharp spike activity or in the duration of sharp spike activity following cessation of needle electrode movement. There was a statistically significant reduction in the total duration of mechanically-provoked electrical activity in the extensor digitorum brevis when compared to the anterior tibialis using the technique employed in this study. There was a statistically significant increase in time following the onset of needle electrode movement until the initiation of sharp spike activity in the extensor hallucis longus as compared to the anterior tibialis. Abnormalities are present in the extensor digitorum brevis muscle of clinically unimpaired subjects. Endplate spikes can be recorded as positive-shaped potentials in the endplate zones of muscle. Nonreproducible positive-shaped potentials of unknown etiology are seen to occur singly or in pairs following insertional activity in normal muscle. When examining muscle for the early evidence of provokable positive sharp wave and fibrillation potentials, care must be taken not to mistake normal characteristics of insertional activity for pathological abnormalities.     

Post stroke hemiplegia: lower limb benefit from botulinum toxin (review)]

OBJECTIVE: To clarify the conditions governing the use of botulinum toxin (BTX) for post-stroke lower limb spastic disorders: indications, choice of muscles, doses, and duration of efficacy. METHOD: Review of the international literature using the Medline and the Reedoc data banks. RESULTS: Seven controlled studies were reviewed, including in particular 2 studies vs placebo and one vs phenol, 7 open studies or case series closely related to this topic and 4 open studies partly dedicated to it. The usefulness of BTX for the treatment of equinovarus has been demonstrated. The main muscles to be treated are the soleus, gastrocnemius and tibialis posterior. The treatment proposed for toe clawing is BTX injection into the flexor digitorum longus and flexor hallucis longus, and for great toe permanent extension, injection of the extensor hallucis longus. The quadriceps femoris, the tibialis anterior or the hamstrings have only be treated in isolated cases. When the treatment is effective, its benefit may last for more than 6 months. DISCUSSION: A few controlled trials have demonstrated the efficacy of BTX for post stroke lower limb spasticity. The results of all the controlled and open trials argue in favor of its efficacy, but this still requires more thorough analysis. CONCLUSION: Botulinum toxin has a place together with other local treatments for post-stroke spasticity, but a precise guide to its use, especially its dosage, and it's effectiveness compared to that of other treatments, need further study.     

Muscle synergism during isometric plantarflexion in achilles tendon rupture patients and in normal subjects revealed by velocity-encoded cine phase-contrast MRI

BACKGROUND: The triceps surae muscle is often considered to be the sole contributor to the plantarflexion torque although the deeper plantarflexor muscles may also be activated in the plantarflexion task. METHODS: We measured coordinative strategies and muscle synergism during isometric plantarflexion task from 11 volunteers. Velocities from the distal end of the medial gastrocnemius, soleus, and flexor hallucis longus muscles were encoded in the superior-inferior direction using cine phase-contrast magnetic resonance imaging. Eight of the subjects were healthy and served as controls for subject to subject variability. Three of the subjects had experienced an Achilles tendon rupture followed by surgical repair and they were measured up to 8 weeks of rehabilitation. RESULTS: There were marked individual differences in the use of the different muscles during plantarflexion task in control subjects. Soleus to flexor hallucis longus displacement ratio during contraction varied from 0.4 to 9.6 while the moment arm ratio between Achilles tendon and flexor hallucis longus tendons was 1.9 (standard deviation 0.2). In Achilles tendon rupture patients the relative contribution of flexor hallucis longus was very high both in their injured and uninjured leg. This coordinative strategy remained throughout rehabilitation. INTERPRETATION: The findings suggest that early recovery of plantarflexion torque after Achilles tendon rupture may be due to compensation by flexor hallucis longus as well as to normalization of the triceps surae muscle function. Also, this study suggests that the individual differences in coordinative strategies in addition to moment arms and muscle-tendon properties can influence the calculation of forces produced by individual muscles.     

高频超声对腕背部囊肿的诊断价值

目的：探讨高频超声对腕背部囊肿的诊断价值。方法回顾136例经手术及术后病理结果证实为腕背部囊肿的超声图像资料,分析其发生部位与声像图特征。结果高频超声诊断腕背部囊肿136例,根据发生解剖层次的不同可分为伸肌支持带囊肿、伸肌腱滑液鞘囊肿和骨间背侧韧带囊肿,所占百分比分别为1.5%（2/136）、24.3%（33/136）和74.2%（101/136）。囊肿具体发生部位排在前3位的是舟月背侧韧带、指伸肌腱及示指伸肌腱滑液鞘、桡侧腕长及腕短伸肌腱滑液鞘,所占百分比分别为60.3%（82/136）、8.1%（11/136）和6.6%（9/136）。腕背部囊肿具有典型的声像图表现：二维灰阶超声显示伸肌支持带囊肿体积较小,呈椭圆形无回声区,边界清晰,位于水肿增厚的伸肌支持带内,与伸肌腱无联系,多同时合并舟月背侧韧带囊肿;伸肌腱滑液鞘囊肿位于伸肌腱旁,呈椭圆形或茄形包绕肌腱,与骨间背侧韧带及伸肌支持带无联系,骨间背侧韧带呈正常的条索状回声,表面光滑、平整;骨间背侧韧带囊肿呈不规则形无回声区,位于受损韧带浅方,受损韧带增厚、回声减低,表面不光整,内部条索状回声连续性完全中断或部分中断致局部变细。彩色多普勒血流成像示腕背部囊肿内均无血流信号。结论高频超声能够对腕背部囊肿作出准确的定位诊断,可作为指导临床治疗首选的影像学检查方法。     

Association between trigger points in hamstring,posterior leg,foot muscles and plantar fasciopathy: A cross- sectional study

BackroundPlantar Fasciopathy (PF) is soreness or irritability experienced underneath infero-medial aspect of the heel. It is a multifactorial disorder where myofascial involvement also seems to be associated with it, in which, muscles of posterior thigh, leg and foot muscles are affected. Trigger points in these muscles may interfere with biomechanics and normal functioning of the lower limb.ObjectiveTo find an association between trigger points of the posterior thigh, leg and foot muscles and plantar fasciopathy.Study designA cross sectional study.Methods100 patients with plantar fasciopathy who fulfilled inclusion criteria were included in this study. They were examined for trigger points by manual palpation in posterior thigh, leg and foot muscles. Totally 15 muscles were examined on both affected and unaffected side.ResultsResults showed that myofascial trigger points were more prevalent in medial gastrocnemius (98%, Chi-square: 110.07, p < 0.05, Phi-0.74), quadratus plantae (83%, Chi-square:126.96, p < 0.05, Phi- 0.79), soleus (69%, Chi-square: 28.88, p < 0.05, Phi-0.38), tibialis posterior (46%, Chi-square 41.98 p<0.05%, Phi-0.50), abductor hallucis (42%, Chi-square: 43.61 p<0.05% Phi-0.46), flexor halluces longus (41%, Chisquare: 39.25, p < 0.05, Phi-0.44) than other muscles on the affected side. Whereas, on the unaffected side, trigger points were more prevalent among peroneus longus (50%, Chi-square: 26.14, p < 0.05, Phi-0.36) followed by medial gastrocnemius (26%, Chisquare: 110.07, p < 0.05, Phi-0.74).ConclusionPlantar fasciopathy is strongly associated with trigger points of medial gastrocnemius, quadratus plantae followed by soleus, tibialis posterior, abductor hallucis and flexor hallucis longus.     

双能CT成像在显示膝关节韧带中的价值

目的 初步探讨双能CT成像在显示膝关节韧带中的价值.方法 对 12 例志愿者行膝关节双能CT 扫描,并均行容积显示(VRT)和多平面重建(MPR)等二维及三维图像后处理,用以显示膝关节的韧带.由2名有经验的放射科医生对图像进行分析.结果 膝关节部分韧带(膑韧带、前、后交叉韧带和腓侧副韧带)亦可清晰的显示;而较薄的韧带(胫侧副韧带)、横行的韧带(如膑内、外侧支持带)和后方的韧带(如恫斜韧带)显示欠佳.结论 双能CT是一种能够多方位、立体、直观地显示膝关节韧带的新方法,对临床应用具有一定的价值.     

Mechanical properties of intrasynovial and extrasynovial tendon fascicles

BACKGROUND: Tendon grafting in tendon reconstruction often involves the interchange of intrasynovial and extrasynovial tendons. Although many studies have examined the cellular and biological differences between tendons of various sources, few have studied the mechanical properties of these two different types of tendons. The purpose of this study was to investigate the mechanical properties of intrasynovial and extrasynovial tendons. METHODS: Canine peroneus longus (extrasynovial) and flexor digitorum profundus (intrasynovial) tendons, further subdivided into intrasynovial tendinous and intrasynovial fibrocartilaginous segments, were used in the study. An indentation test was used to measure the compressive modulus. Tensile testing was performed on 400mum longitudinal sections. FINDINGS: The compressive modulus of the intrasynovial fibrocartilaginous segment was significantly higher than that of the intrasynovial tendinous segment, which was in turn significantly higher than that of the extrasynovial tendon (P<0.0001). The tensile modulus of extrasynovial tendon was significantly higher than that of intrasynovial fibrocartilaginous and intrasynovial tendinous segments (P<0.005). The tensile modulus of the intrasynovial fibrocartilaginous and tendinous segments was not significantly different (P=0.14). INTERPRETATION: The results suggest that extrasynovial tendons exhibit superior tensile properties but inferior compressive properties when compared to intrasynovial tendons, which is consistent with their biological role in situ, but which could lead to complications when these tendons are repositioned during tendon graft surgery.     

A biomechanical analysis of posterior tibial tendon dysfunction,medial displacement calcaneal osteotomy and flexor digitorum longus transfer in adult acquired flat foot

Background

Biomechanical models have been used to study stress in the metatarsals, subtalar motion, lateral column lengthening and subtalar arthroereisis. Posterior tibial tendon dysfunction has been associated with increased loads in the arch of the acquired flat foot. We examine whether a 10 millimeter (mm) medial displacement calcaneal osteotomy and flexor digitorum longus transfer to the navicular reduces these increased loads in the flat foot.

Methods

The response of a normal foot, a foot with posterior tibial tendon dysfunction, and a flat foot to an applied load of 683 Newton was analyzed using a multi-segment biomechanical model. The distribution of load on the metatarsals, the moment about each joint, the force on each of the plantar ligaments and the muscle forces were computed.

Findings

Posterior tibial tendon dysfunction results in increased load on the medial arch, which may cause the foot to flatten. A 10 mm medial displacement calcaneal osteotomy substantially decreases the load on the first metatarsal and the moment at the talo-navicular joint and increases the load on the fifth metatarsal and the calcaneal-cuboid joint. Adding the flexor digitorum longus transfer to the medial displacement calcaneal osteotomy has only a small effect on the flattened foot.

Interpretation

Our biomechanical analysis illustrates that when the foot becomes flat, the force on the talo-navicular joint increases substantially from its value for the normal foot, and that medial displacement calcaneal osteotomy can reduce this increased force back toward the value occurring in the normal foot. This study provides a biomechanical rationale for medial displacement calcaneal osteotomy treatments for posterior tibial tendon dysfunction.     

Peroneus Longus overload caused by soft tissue deficiencies associated with early adult acquired flatfoot: A finite element analysis

BackgroundPeroneus Longus tendinopathy has been related to overload from cavus and ankle instability. The etiology of isolated Peroneus Longus tendon synovitis has not been elucidated. Loss of foot arch integrity as a cause of isolated Peroneus Longus overload is difficult to establish using cadaver modeling. Our objective was to analyze Peroneus Longus stress changes in pathological scenarios related to flatfoot development.MethodsA three-dimensional finite element foot model which included the foot bones and main soft tissues that maintain the arch was used. Simulations were performed in midstance of gait. Tendon's maximum principal stress and von Mises were calculated in scenarios where the plantar fascia, spring ligament and the posterior tibial tendon were weakened.FindingsDecreasing plantar fascia stiffness thus weakening arch integrity increases Peroneus Longus stresses by over three times. Additional failure of tissues that support arch, such as the spring ligament and tibialis posterior tendon further overloads this tendon. The absence of Peroneus Longus also affects stresses in tissues that maintain the arch. Stress concentrations increase in the plantar component of the Peroneus Longus.InterpretationResults offer an explanation into isolated Peroneus Longus overload synovitis. Recognition of failing medial arch structures that occur in early acquired flatfoot as a cause of Peroneus Longus overload could help in its treatment. We caution the practice of transfer of peroneus brevis to longus in surgical treatment of flatfoot as it may further overload an overloaded tendon and focus should be on restoration of arch stability to offload stresses within it.     

Tendon injuries of the lower extremity: magnetic resonance assessment

MR is rapidly establishing itself as a premiere imaging modality for the assessment of musculoskeletal trauma. Its utility in the evaluation of the menisci and ligaments of the knee is well known, but there is far less known about the use of MR for evaluation of the tendons. MR, by virtue of its unmatched soft tissue resolution capability, can determine not only the contour of an affected tendon, but the tendon sheath and internal signal alterations that accompany tendonitis, partial and complete ruptures. Injuries to the Achilles tendon are well known to the athlete and the imager alike; however, abnormalities of the posterior tibial tendon, peroneal tendon, and flexor hallucis longus also result in significant clinical symptoms, as well as imaging abnormalities.     

鸡趾屈肌腱鞘内损伤修复后的愈合和bFGF的表达

目的：了解鸡趾屈肌腱鞘内损伤修复后碱性成纤维细胞生长因子（bFGF）的表达及其与肌腱愈合的关系。方法：将36只来亨鸡的右足第3趾趾屈长肌腱切断后缝合并重新覆以腱鞘，于术后不同时间点切取标本（每个时间点6只），另取6只未行手术处理鸡的肌腱标本作为对照。将标本行组织学检查，并用RT—PCR和免疫组化方法测定肌腱bFGF的表达。结果：肌腱修复后断端先出现炎细胞浸润。接着成纤维细胞聚集并分泌胶原，最后胶原纤维重新塑形。这些细胞活动在腱实质比腱鞘、腱外膜出现迟且弱。bFGF在对照组肌腱仅出现低水平表达．而在实验组肌腱各个时间点均明显上调；腱鞘、腱外膜的表达明显高于腱实质。结论：bFGF参与了鸡趾屈肌腱损伤修复的愈合过程。     

髌支持带MR成像的初步研究

目的　观察髌支持带中各结构在不同方位成像上的MRI表现 ,明确其最佳MRI显示方法。方法　对 2 0例 40侧正常膝关节进行冠状、矢状、横轴及斜位T1WI扫描 ,观察髌支持带在不同方位成像上的MRI表现。结果　髌支持带包括髌内、外侧支持带 ,又可分为浅、深两层。髌内侧支持带深层包括内侧髌股韧带、内侧髌胫韧带和内侧髌半月板韧带 ;髌外侧支持带深层包括横韧带、外侧髌胫韧带和上髁髌韧带。在MRI上 ,内侧髌股韧带和横韧带在横轴像显示最佳 ;内侧髌胫韧带在冠状像或矢状像显示最佳 ;内侧髌半月板韧带和外侧髌胫韧带分别在 70 °内斜和 70 °外斜矢状斜位像显示较好。上髁髌韧带显示不佳。结论　MRI多方位成像可较好地显示髌支持带的解剖结构。