目的 分析髂胫束摩擦综合征(ITBFS)的MRI特征,探讨ITBFS与膝关节外上髁突出的相关性。方法 选择2021-01至2023-12武警浙江总队医院临床诊断为ITBFS患者60例(病例组),另选60例有运动史并膝关节疼痛,MRI呈阴性的患者为对照组。两组均行MRI检查,观察分析两组ITBFS的MRI影像学特征,测量并对比膝关节髂胫束厚度、外上髁高度和外侧髁厚度。结果 ITBFS患者的MRI图像上表现为髂胫束不均匀增厚、局部信号增高,髂胫束与股骨外侧髁之间脂肪组织水肿或局限性积液,可伴有髂胫束附着处的骨髓水肿;病例组股骨外侧髁水平髂胫束厚度[(4.23±0.78)mm]较对照组[(2.91±0.43)mm]明显增厚(P<0.01),且慢性期髂胫束厚度[(4.53±0.83)mm]较急性期髂胫束厚度[(3.96±0.62)mm]增厚,差异有统计学意义(P＜0.05);病例组膝关节外上髁高度[(14.33±0.95)mm]高于对照组外上髁高度[(12.61±0.98)mm],差异有统计学意义(P＜0.05)。两组患者外侧髁厚度相似,但病例组股骨外侧髁高度指数(外上髁高度/外侧髁厚度)显著高于对照组,差异有统计学意义(P＜0.05)。结论 膝关节外上髁突出是ITBFS发病的解剖学高危因素,ITBFS的MRI具有典型的影像特征。
Abstract
Objective To analyze MRI features of iliotibial band friction syndrome (ITBFS) and to explore the correlation between ITBFS and lateral epicondylar protrusion of knee joint. Methods A total of 60 patients with clinical diagnosis of ITBFS from January 2021 to December 2023 were selected as case group and another 60 patients with exercise history and knee pain with negative MRI were selected as control group. The MRI imaging features of ITBFS in both groups were observed and analyzed, and the knee iliotibial band thickness, lateral epicondyle height and lateral condyle thickness were measured and compared between the two groups. Results MRI images of ITBFS patients showed uneven thickening of iliotibial band, increased local signal, edema of adipose tissue or localized effusion between iliotibial band and lateral femoral condyle, accompanied by bone marrow edema at the iliotibial band attachment. The horizontal iliotibial tract thickness of lateral femoral condyle [(4.23±0.78)mm]in the case group was significantly thicker than that of control group [(2.91±0.43)mm] (P<0.05). The iliotibial tract thickness of chronic phase [(4.53±0.83)mm] was significantly thicker than that of acute phase [(3.96±0.62)mm] , and the difference was statistically significant (P<0.05). The lateral condyle height of the knee in the case group [(14.33±0.95)mm] was higher than that of the control group [(12.61±0.98)mm], and the difference was statistically significant (P<0.05). Lateral condyle thickness was similar between the two groups, but the lateral condyle height index (lateral epicondyle height/lateral condyle thickness) in the case group was significantly higher than that in the control group, with statistical significance (0.23±0.02) (P<0.05). Conclusions Protrusion of lateral epicondyle of knee joint is a high risk factor of ITBFS. MRI of ITBFS has typical imaging features.
关键词
髂胫束摩擦综合征 /
膝关节 /
MRI /
运动伤 /
股骨外上髁
Key words
iliotibial band friction syndrome /
knee joint /
MRI /
sports injury /
lateral epicondyle of femur
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Everhart J S, Kirven J C, Higgins J, et al. The relationship between lateral epicondyle morphology and iliotibial band friction syndrome:a matched case-control study[J]. Knee,2019,26(6):1198-1203.
[2] Russel F, Giovanni J P, Matthew R S, et al. The iliotibial tract: imaging, anatomy, injuries, and other pathology[J]. Skeletal Radiol, 2017, 46(5): 605-622.
[3] 闫 君, 邢更彦. 髂胫束综合征临床诊断及其治疗进展[J]. 武警医学, 2023, 34(10): 910-913.
[4] 符 熙, 张家雄, 彭加友,等. 髂胫束摩擦综合征MRI特征及发病机制相关研究[J]. 放射学实践, 2022, 37(3): 363-366.
[5] Diaz F J, Gitto S, Sconfienza L M, et al. Ultrasound of iliotibial band syndrome[J]. J Ultrasound, 2020, 23(3): 379-385.
[6] Ucpinar B A, Bankaoglu M, Eren O T, et al. Measurement of iliotibial band diameter in iliotibial band friction syndrome and comparison with an asymptomatic population[J]. Acta Radiologica, 2021, 69(9): 1188-1192.
[7] 郭彩凤, 张 涛, 宋田君. 髂胫束摩擦综合征3.0T磁共振诊断及临床价值[J]. 转化医学电子杂志, 2017, 4(1): 46-48.
[8] 苏 祁, 张 堃, 朱 璐,等. MRI对髂胫束综合征的诊断价值[J]. 中国中西医结合影像学杂志, 2016, 14(1): 65-67.
[9] Hamill J, Miller R, Noehren B, et al. A prospective study of iliotibial band strain in runner[J]. Clin Biomech, 2008, 23(8): 1018-25.
[10] 闫 燃, 黄振国, 王丽雯,等. 髂胫束摩擦综合征的MR表现及临床价值[J]. 中华医学杂志, 2014, 94(19): 1473-1475.
[11] 张联合,吴赤球,陈长松. 常见军事训练伤影像学诊断[M]. 北京:军事科学出版社,2024:61-62.
[12] Jia L, Bo S, Lan Q Y, et al. A quantitative MRI investigation of the association between iliotibial band syndrome and patellofemoral malalignment[J]. Quant Imaging Med Surg, 2021, 11(7): 3209-3218.
[13] Fairclough J, Hayashi K, Toumi H, et al. The functional anatomy of the iliotibial band during flexion and extension of the knee: inplications for understanding iliotibial band sysdrome[J]. J Anat, 2006, 208(3): 309-16.
[14] 丁 龙, 滕录霞, 骆玉辉. 髂胫束摩擦综合征临床与MR表现特点[J]. 现代医用影像学, 2021, 30(1): 34-37.
[15] Kim J K, Kim T, Lee H S, et al. Feasibility and reliability of various morphologic features on magnetic resonance imaging for iliotibial band friction syndrome[J]. Korean J Pain, 2023, 36(2): 208-215.
[16] 丁谷渊,史申宇,凌晓宇,等.髂胫束综合征的临床诊治研究进展[J].中国骨伤,2018,31(10):965-970.
PDF(1336 KB)
