摘要
目的分析踝关节骨髓水肿综合征（BMES）患者的临床表现和MRI成像特点,为临床诊治提供依据。方法回顾性分析2011年4月—2012年5月河北医科大学第二医院确诊的67例踝关节BMES患者的临床资料,包括人口统计数据、药物和手术治疗史、预后及门诊随访资料。门诊随访内容：记录视觉模拟评分（VAS）、美国足踝外科协会踝-后足评分系统（AOFAS）评分,应用3.0 T磁共振成像仪进行扫描,包括T1和T2加权像,并记录距骨骨髓水肿面积。结果患者均接受了非手术治疗,29例患者接受了口服非甾体类抗炎药、物理因子治疗,保护性负重;18例患者接受了中药熏蒸、关节松动术、带或不带支具的部分负重;20例患者先后接受上述两种治疗。经过治疗后,61例患者的症状完全消失,保守治疗的平均时间为2.4个月。患者随访不同时间点VAS、AOFAS评分和距骨骨髓水肿面积比较,差异均有统计学意义（P〈0.05）。患者AOFAS评分优良率为92.5%（62/67）。患者初诊MRI表现：T2加权像为弥漫性、不规则增强信号,T1加权像为边界不清的低信号区。63例患者MRI水肿消退与临床症状的改善一致。踝关节BMES受累骨骼2~6块。结论踝关节BMES MRI成像特点为T1加权像变量区域低信号,T2加权像表现为不规则的弥漫性高信号。患者MRI显示距骨均有骨髓水肿表现,受累踝关节骨骼至少为2块。此外,多数患者MRI改变与临床症状一致。
Objective To analyze the clinical manifestation and the characteristics of MRI of patients with bone marrow edema syndrome（BMES） in order to provide references for clinical diagnosis and treatment.Methods We made a retrospective analysis of the clinical data of 67 patients who were diagnosed with BMES in ankle joint in the Second Hospital of Hebei Medical University from April 2011 to May 2012.The data included demographic data,medication,history of surgery and treatment,prognosis and follow-up data.The subjects were asked to make regular follow-up visits,during which VAS and AOFAS scores were evaluated,3.0 T MRI scanning was conducted,including T1 WI and T2 WI,and the area of marrow edema in ankle bone was also recorded.Results The patients all received nonsurgical treatment.There were 29 patients who took oral non-steroid anti-inflammatory agents,physical agent therapy and protective load-bearing therapy,18 patients who received TCM fumigation,joint mobilization and partial load-bearing with or without brace,and 20 patients who received both of the two regimens.After treatment,61 subjects had their symptoms disappear,and the average length of conservative treatment was 2.4months.The patients had different（P 0.05） VAS scores,AOFAS scores and bone marrow edema areas at different time points.The proportion of patients who had good AOFAS score was 92.5%（62/67）.The first MRI showed T2 MI images with diffusive and irregular enhancement signal and T1 MI images with obscure boundary and low signals.There were 63 patients whose alleviation of clinical symptoms was consistent with MRI results.The number of bones influenced by BMES was 2-6.Conclusion MRI of BMES in ankle joint showed T2 MI images with diffusive and irregular enhancement signal and T1 MI images with low signals in variable area.By MRI,all subjects were noted with BMES in ankle joint,and the minimum number of influenced bones was 2.Besides,most patients found their MRI changes consistent with the changes of clinical symptoms.
出处
《中国全科医学》
CAS
CSCD
北大核心
2015年第20期2481-2484,共4页
Chinese General Practice
关键词
骨髓水肿
踝关节
疼痛
磁共振成像
Bone marrow edema
Ankle joint
Pain
Magnetic resonance imaging
