前交叉韧带撕脱骨折

介绍
自行车事故。

患者资料
年龄：15岁
性别：男

MRI

Sagittal T1


Coronal T1


Sagittal PD fat sat


Coronal PD fat sat


Axial PD fat sat

MRI序列显示：

前交叉韧带胫骨止点前髁间隆起撕脱骨折伴骨碎片完全分离。

肿胀的前交叉韧带附着在骨头碎片上

胫骨和腓骨骨骺的骨髓水肿

股骨外侧髁软骨下骨折伴骨髓水肿

中度关节炎。

后角内侧半月板纵裂

腘窝小囊肿

案例讨论

根据Meyers和McKeevers分类的3b型前交叉韧带撕脱骨折的CT表现，伴有股骨外侧髁软骨下骨折和内侧半月板纵行撕裂。

软骨下骨折是指软骨下骨板正下方的松质骨小梁骨折，关节面没有破坏。

流行病学

软骨下功能不全骨折在老年妇女中更为常见。外伤引起的软骨下骨折可以在任何年龄发生。

参考资料：
1. Gorbachova T, Melenevsky Y, Cohen M, et al. Osteochondral Lesions of the Knee: Differentiating the Most Common Entities at MRI. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (5): 1478-1495. doi:10.1148/rg.2018180044 - Pubmed
2. Polesello G, Sakai DS, Ono NK, et al. THE IMPORTANCE OF THE DIAGNOSIS OF SUBCHONDRAL FRACTURE OF THE FEMORAL HEAD, HOW TO DIFFERENTIATE IT FROM AVASCULAR NECROSIS AND HOW TO TREAT IT. (2009) Revista brasileira de ortopedia. 44 (2): 102-5. doi:10.1016/S2255-4971(15)30055-0 - Pubmed
3. Pathria MN, Chung CB, Resnick DL. Acute and Stress-related Injuries of Bone and Cartilage: Pertinent Anatomy, Basic Biomechanics, and Imaging Perspective. (2016) Radiology. 280 (1): 21-38. doi:10.1148/radiol.16142305 - Pubmed
4. Yamamoto T. Subchondral insufficiency fractures of the femoral head. (2012) Clinics in orthopedic surgery. 4 (3): 173-80. doi:10.4055/cios.2012.4.3.173 - Pubmed
5. Burdett PH. Subchondral fractures – Radsource MRI Web Clinic September 2019
6. Ikemura S, Yamamoto T, Motomura G, et al. MRI evaluation of collapsed femoral heads in patients 60 years old or older: Differentiation of subchondral insufficiency fracture from osteonecrosis of the femoral head. (2010) AJR. American journal of roentgenology. 195 (1): W63-8. doi:10.2214/AJR.09.3271 - Pubmed