前交叉韧带重建术后关节感染与粘连的MRI征象

目的 探讨正常成人足底跖骨水平高频超声检查方法及声像图表现。方法 采用高频超声扫查40名正常成人足底跖骨水平，以第一至五跖骨底、体、头作为解剖标志，描述并记录声像图特点及扫查方法。结果 高频超声可清晰显示足底跖骨水平的皮肤、足底脂肪垫、足底腱膜及其深部肌肉结构，包括趾短屈肌、展肌、小趾展肌、蚓状肌、短屈肌、小趾短屈肌、收肌及骨间足底肌。结论 高频超声可清晰显示足底跖骨水平肌肉骨骼系统解剖结构。

MRI findings of joint infection and adhesion after anterior cruciate ligament reconstruction

Objective To analyze the joint lesions of synovial thickening after anterior cruciate ligament (ACL) reconstruction, and to explore the differences of MRI findings between joint infection and adhesion. Methods Clinical and MRI data of 25 patients with synovial thickening (11 with infections and 14 with adhesion) confirmed by arthroscopy were retrospectively analyzed. The time interval from first ACL reconstruction to the arthroscopy after ACL was 0.3-2.5 (mean) months and 6.0-19.0 (mean) months, respectively. Results The lesions caused synovial thickening on MRI included joint infection and joint adhesion. MRI findings of joint infection included synovial thickening, moderate to massive joint effusion, different degrees of soft tissue swelling, bone marrow edema of distal femur and proximal tibia, ACL graft continuous fiber (high signals in 5 patients) and bone tunnel pseudo widened in 5 patients, while of joint adhesion included synovial thickening, striped short T2 signals in part of the thickened synovium on suprapatellar bursa, medial and lateral recess, the infrapatellar fat pad and the intercondylar fossa, without or only a small amount of joint effusion, ACL graft continuous, as well as high signals and rough edge in 3 patients, while bone tunnel was not significantly widened. Statistical differences of joint effusion, soft tissue swelling, edema of bone marrow and bone tunnel pseudo widened were found between joint infection and joint adhesion (all P<0.05). Conclusion MRI findings of joint infection mainly included synovial thickening, joint effusion and high signal of joint cavity, while of joint adhesion were synovial thickening, equal or slightly high signal of joint cavity. Joint infections mainly occurred in the early stage after operation, while joint adhesions mainly occurred in the middle and late stage after operation.