膝关节隐匿性骨折的MRI诊断价值探讨

目的 探讨膝关节隐匿性骨折的MRI特征和临床应用价值．方法 选择35例膝关节外伤后X线检查阴性但有明显疼痛等症状的患者进行研究，所有患者全部进行MRI检查．重点观察股骨下端、胫腓骨上端及髌骨的骨质信号．前后交叉韧带、内外侧副韧带、内外侧半月板的完整性和信号异常情况。结果 隐匿性骨折的好发部位为：胫骨内外侧平台(14／35)、股骨内外侧髁(I3／35），35例患者中X线检查全部阴性，其中CT检查11例，3例阳性(27％)，MRI检查全部阳性(100％)。结论 MRI是检查隐匿性骨折的最佳影像学方法，对于X线或CT显示正常但又有明显症状的膝关节外伤患者，应做MRI检查，以防漏诊和误诊。

Investigation into MRI diagnostic value of occult fracture of knee

Objective To investigate the MRI manifestation of knee joint occult fracture and its clinical value. Methods 35 cases who suffered from obvious pain after knee trauma but were not diagnosed as having fracture by X ray were analyzed and given re examination of MRI. The MRI signals were focused on femur, fibula and patella, anterior and posterior cruciate ligament, media and lateral meniscus. Results All the 35 cases who had been diagnosed as normal by X ray film were found to have occult fractures by MRI. Of the 35 cases, 11 case had CT scanning and 3 were found to have occult fracture. The most frequent sites of occult fracture were medial and lateral condyle of femur (13/35) and tibial plateau (14/35). Conclusion MRI is the best method in the diagnosis of occult fracture of knee joint. For patients with obvious knee joint pain after injury the MR scanning is necessary even when their X ray and /or CT results are normal so that the misdiagnosis and delayed diagnosis can be avoided as much as possible.