Multidetector computed tomography and magnetic resonance imaging of acute knee trauma

Tutkimustuotos: OpinnäyteVäitöskirjaArtikkelikokoelma

Abstrakti

The main purpose of this thesis was to evaluate the incidence, injury patterns and MRI and MDCT findings of the acute trauma patients with knee dislocation, patellar dislocation, Segond fracture and reverse Segond fracture, and also to examine dual-energy computed tomography in evaluating cruciate ligament injuries. At a level 1 trauma center, emergency department acute trauma patients MDCT or MRI examinations were retrospectively evaluated and surgical findings or MRI served as the reference standard for intra-articular injuries. The annual incidence of knee dislocation due to low energy trauma in overweight patients was found to be significant, about 1.0 per million, and these patients had no injuries to the popliteal tendon and no irreversible peroneal nerve injuries, otherwise, the patients injuries were in agreement with previous knee dislocation studies. Of the bony fragments that were seen on MDCT images in patellar dislocation patients 59% were not seen on AP and lateral views of the conventional radiographs. The location, size and donor site of the bony fragments was similar between first-time and recurrent patellar dislocators. Patients with a Segond fracture associated with a tibial plateau fracture had significantly fewer ACL ruptures and more avulsion fractures of the ACL than patients with isolated Segond fractures. In approximately one of every 32 tibial plateau fractures, a Segond fracture also coexists. In 0.64 % of the emergency room acute knee trauma MDCT examinations a reverse Segond fracture were found. Of the operated reverse Segond fracture patients 43% had an avulsion fracture of the ACL, and 14% had a PCL rupture. DECT s sensitivity and specificity to detect ACL rupture were 79 % and 100 %, respectively, and the intra- and interobserver proportions of agreement for ACL rupture were excellent and good. The radiologist should be aware that even after a simple fall, overweight patients may have a knee dislocation. Patients with a Segond fracture combined with a tibial plateau fracture have a high risk of avulsion fracture of the ACL. In previous reports, reverse Segond fracture have been associated with PCL injury, but our results do not support this association. DECT is a usable method to evaluate ACL in acute knee trauma patients with rather good sensitivity and high specificity.
Alkuperäiskielienglanti
JulkaisupaikkaHelsinki
Kustantaja
Painoksen ISBN978-951-51-2680-1
Sähköinen ISBN978-951-51-2681-8
TilaJulkaistu - 2016
OKM-julkaisutyyppiG5 Tohtorinväitöskirja (artikkeli)

Lisätietoja

M1 - 67 s. + liitteet

Helsingin yliopisto
Volume:
Proceeding volume:

Tieteenalat

  • Anterior Cruciate Ligament
  • +injuries
  • Arthrography
  • Incidence
  • Knee Dislocation
  • +diagnosis
  • +epidemiology
  • Knee Joint
  • +radiography
  • Knee Injuries
  • Leg Bones
  • Magnetic Resonance Imaging
  • Menisci, Tibial
  • Multidetector Computed Tomography
  • +methods
  • Overweight
  • Patella
  • Patellar Dislocation
  • Posterior Cruciate Ligament
  • Radiographic Image Interpretation, Computer-Assisted
  • Radiography, Dual-Energy Scanned Projection
  • Risk Assessment
  • Sensitivity and Specificity
  • Tibial Fractures
  • Tomography, X-Ray Computed
  • 3126 Kirurgia, anestesiologia, tehohoito, radiologia

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