RESUMO
Magnetic resonance imaging (MRI) is useful in the diagnosis of meniscal lesions of the knee. The purpose of this study was to relate the findings of MRI and arthroscopy and to evaluate the morphology of the menisci with tears. 39 patients of both genders were included, whose age range was 13 to 74 years old (mean: 42.6 years), with and without a history of trauma, who underwent MRI and arthroscopy of the knee, due to symptoms of articular lesion. The images of magnetic resonances were analyzed independently by two specialists prior to the arthroscopy. The measurements of the medial and lateral menisci were made in each meniscal horn with sagital images in protonic density and fat-suppression. MRI detected 8 cases of tear of the lateral meniscus of the 11 catalogued by arthroscopy, and 11 cases of tears of the medial meniscus of the 13 catalogued by arthroscopy. The sensibility and specificity of MRI for the lateral meniscal tears were 72% and 100%, and for the medial tears were 85% and 89%. The meniscal tears were localized mainly in the posterior horn. The dimensions of the posterior horn of the lateral meniscus were larger in disrupted menisci (height, 7.1 +/- 1.3 mm vs. 6.1 +/- 0.7 mm, p < .05; wide, 10.2 +/- 1.6 mm vs. 8.8 +/- 1.3 mm, p < 0.05). A meniscal tear produces morphological changes, particularly in the posterior horn of the lateral meniscus. Magnetic resonance constitutes the imaging technique of choice for the diagnosis of the meniscal tears.
Assuntos
Artroscopia , Traumatismos do Joelho/diagnóstico , Imageamento por Ressonância Magnética , Meniscos Tibiais/patologia , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Traumatismos do Joelho/patologia , Traumatismos do Joelho/cirurgia , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Ruptura/diagnóstico , Ruptura/patologia , Ruptura/cirurgia , Sensibilidade e Especificidade , Lesões do Menisco Tibial , Adulto JovemRESUMO
Las imágenes de resonancia magnética (IRM) son de utilidad en el diagnóstico de lesiones meniscales de la rodilla. El objetivo fue relacionar los hallazgos de las IRM y de la artroscopia, y valorar la morfología de los meniscos con rupturas. En el estudio se incluyeron 39 pacientes, de ambos sexos, cuyo rango de edad fue de 13 a 74 años (media: 42,6 años), con y sin antecedentes de trauma, a quienes se le indicó estudio de IRM y artroscopia de la rodilla, debido a clínica de lesión articular. Las IRM fueron analizadas por dos especialistas de manera independiente antes de la artroscopia. Las mediciones de los meniscos medial y lateral se realizaron en cada cuerno meniscal en las imágenes sagitales, en densidad protónica y en supresión grasa. Las IRM detectaron 8 casos de ruptura del menisco lateral de los 11 catalogados por artroscopia y 11 casos de ruptura del medial de los 13 precisados artroscópicamente. La sensibilidad y especificidad de las IRM para las rupturas meniscales laterales fueron 72% y 100%, y para las mediales, 85% y 89%. Las rupturas meniscales afectaron mayormente al cuerno posterior. Las dimensiones del cuerno posterior del menisco lateral fueron mayores en meniscos rotos (altura, 7,1 ± 1,3 mm vs 6,1 ± 0,7 mm, p < 0,05; ancho, 10, 2 ± 1,6 mm vs 8,8 ± 1,3 mm, p < 0,05). La ruptura meniscal condiciona cambios morfológicos particularmente en el cuerno posterior del menisco lateral. La resonancia magnética constituye la técnica de imágenes de elección para el diagnóstico de las lesiones meniscales.
Magnetic resonance imaging (MRI) is useful in the diagnosis of meniscal lesions of the knee. The purpose of this study was to relate the findings of MRI and arthroscopy and to evaluate the morphology of the menisci with tears. 39 patients of both genders were included, whose age range was 13 to 74 years old (mean: 42.6 years), with and without a history of trauma, who underwent MRI and arthroscopy of the knee, due to symptoms of articular lesion. The images of magnetic resonances were analyzed independently by two specialists prior to the arthroscopy. The measurements of the medial and lateral menisci were made in each meniscal horn with sagital images in protonic density and fat-suppression. MRI detected 8 cases of tear of the lateral meniscus of the 11 catalogued by arthroscopy, and 11 cases of tears of the medial meniscus of the 13 catalogued by arthroscopy. The sensibility and specificity of MRI for the lateral meniscal tears were 72% and 100%, and for the medial tears were 85% and 89%. The meniscal tears were localized mainly in the posterior horn. The dimensions of the posterior horn of the lateral meniscus were larger in disrupted menisci (height, 7.1±1.3 mm vs. 6.1 ± 0.7 mm, p <.05; wide, 10.2 ± 1.6 mm vs. 8.8 ± 1.3 mm, p < 0.05). A meniscal tear produces morphological changes, particularly in the posterior horn of the lateral meniscus. Magnetic resonance constitutes the imaging technique of choice for the diagnosis of the meniscal tears.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Artroscopia/métodos , Espectroscopia de Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética , Traumatismos do Joelho/diagnóstico , Traumatismos do JoelhoRESUMO
La condromalacia patelar está asociada a inestabilidad rotuliana. La inclinación troclear femoral lateral se ha vinculado a inestabilidad patelar, pero no se conoce su asociación con la condromalacia patelar. Se incluyeron 39 pacientes, ambos sexos, edades de 13-74 años, a quienes se realizó resonancia magnética y artroscopia de la rodilla. La sensibilidad y especificidad de la resonancia magnética para la condromalacia patelar fue 84 por ciento y 71,4 por ciento. El grado leve de condromalacia patelar afectó más a hombres y pacientes más jóvenes, mientras que los grados moderado y severo afectaron más al sexo femenino y pacientes de más edad. No hubo diferencias significativas entre los valores de inclinación troclear femoral lateral de los pacientes con y sin condromalacia patelar. Sin embargo, en la condromalacia patelar severa la inclinación troclear femoral lateral fue menor, particularmente en comparación a los casos moderados (17,6º vs. 21,8º, P=0,06). La inclinación troclear femoral lateral y la inestabilidad patelar podrían estar asociadas a condromalacia patelar severa, pudiendo condicionar progresión de la enfermedad
The patellar chondromalacia is associated to rotulian instability. The lateral femoral troclear inclination is linked to patellar inestabily; however, there are not studies about linking it to patellar chondromalacia. 39 patients of both genders were included; age range between 13-74 years, who underwent magnetic resonance and arthroscopy of the knee. The sensitivity and specificity of the magnetic resonance for patellar chondromalacia were 84 percent and 71.4 percent. Mild cases were more frequents in men and younger subjects. Moderate and severe grades were more frequents in the femenine gender and affect older patients. There were not significant differences between the values of lateral femoral troclear inclination of the patients with and without chondromalacia patellar. However, the lateral femoral troclear inclination was lower in the severe patellar chondromalacia, particularly in comparison to moderate cases (17.6º vs. 21.8º, P=0.06). The lateral femoral troclear inclination and patellar instability could be associated to severe patellar chondromalacia; They may be according the progression of the disease