2005, Number 4
Utility of the Magnetic Resonance in the ligamentuos lesions and knee meniscus
Meza HRG, Cano MI
Full text
Language: Spanish
References: 3
Page: 339-348
PDF size: 400.95 Kb.
ABSTRACT
Objective: To show the ligamentous pathology and knee meniscus injuries of traumatic origin as well as the presentation through image by means of the different methods of study, besides the surgical correlation of these lesions.Introduction: A traumatism on the knee can produce the following lesions: multiple bruises or contusions, traumatic hemarthrosis, capsule- ligamentous lesions, meniscus rupture, knee cap fractures, of tibial plates, of femoral condyles, etc. In the meniscus lesions, the meniscus that more frequently is injured he/she is the inner meniscus, and the rupture type is variable: longitudinal tear, along the body of the meniscus (in “bucket or pail handle”) detachment of the partial meniscus or in all insertion in the articular capsule; oblique tear in the body of the meniscus, it separates an epiglottis in the internal border, cross-sectional rupture in which the meniscus is separated into two portions; irregular rupture in which the meniscus is virtually crushed by the compression of the femoral condyle. From the ligamentous lesions, the more frequently injured ligaments are: the inner collateral meniscus and the cross-anterior meniscus.
Material and methods: The revision of both, clinical and radiological files was made in 152 patients admitted with knee traumatism diagnosis, as well as the arthroscopy studies, being that the most frequent lesions are meniscus injury/rupture ligaments rupture, meniscus lesion + ligament injury, chondromalacia, synovitis, tendonitis and meniscus discoid.
Results: The most frequent lesions were the contusion and rupture of menisci in 71 patients, 39 of them in the lateral meniscus and 32 in the medial one. A high ratio corresponds to a combination of meniscus lesion with partial or total rupture of the anterior crossed ligament (29 cases). Isolated lesions were also presented or in combination with the above, manifested with chondromalacia in 10 patients, synovitis in 9 and osteochondritis in 6. The presence of meniscus discoid was identified in 6 patients, 4 in the right side and 2 in the left side.
Discussion: The ideal technique should provide images with a good contrast and space resolution of the bone structures and of soft tissues at a time reasonable. The arthrography, although harmless, it is not exempted from complications and the arthroscopy is a surgical procedure that requires anesthesia and surgery room. The accuracy ratio of arthrography in the diagnosis of meniscus lesions ranges from 70 to 90%. Magnetic Resonance has obvious advantages on these methods: it is non-invasive, it doesn’t use ionizing radiation, and yields an excellent contrast- resolution in the soft tissues. Furthermore, images can be obtained at multiple planes, sagittal, axial, coronal and, in some cases, oblique views. It has a high sensitivity in the diagnosis of meniscus and ligaments lesions when correlating it with the surgical results.
REFERENCES