背景技术圆韧带已被认为是髋关节的重要稳定器,并且可受到各种髋关节病变的影响。这项研究旨在介绍韧带圆水肿作为MRI标记,以诊断髋关节病理的根本原因,主要是股骨髋臼撞击(FAI)和成人发育性髋关节发育不良(ADDH),在非创伤性患者中。方法纳入2014年至2020年在MRI上表现为不同持续时间的非创伤性髋部疼痛和圆韧带水肿的成年患者。本系列所有患者均采用高分辨率标准MRI髋关节方案。评估MRI和X线平片。圆韧带水肿,α角,Wiberg的中心边缘角,并对逆行进行了评估。结果总计,55例患者110个髋关节(男性:29(52.7%),女性:26(47.3%))不同种族的人被纳入本研究。在55例圆韧带水肿患者中,一个人只有单方面的右翼FAI,七个人只有单边左翼FAI,46个(94个髋关节)有双侧FAI或ADDH。因此,8例(14.5%)单侧FAI患者没有对侧FAI或ADDH(6.5%假阳性),尽管双侧存在圆韧带水肿,其余双侧韧带圆水肿患者(102个关节:阳性预测值92.7%)有FAI或ADDH的发现。结论圆韧带水肿可作为诊断症状性髋关节疼痛性疾病的早期MRI标志物。尤其是FAI。
Background The ligamentum teres has been recognized as an important stabilizer of the hip joint and can be affected by various hip pathologies. This
study aims to introduce ligamentum teres edema as an MRI marker to diagnose the underlying cause of hip pathology, mainly femoral acetabular impingement (FAI) and adult developmental dysplasia of the hip (ADDH), in non-traumatic patients. Methodology Adult patients presenting with non-traumatic hip pain of variable duration and ligamentum teres edema on MRI between 2014 and 2020 were included. A high-resolution standard MRI hip protocol was used for all patients in this series. MRI and plain radiographs were assessed. Ligamentum teres edema, alpha angle, center edge angle of Wiberg, and retroversion were assessed. Results In total, 55 patients with 110 hip joints (males: 29 (52.7%), females: 26 (47.3%)) of different ethnicities were included in this
study. Out of the 55 patients with ligamentum teres edema, one had only unilateral right-sided FAI, seven had only unilateral left-sided FAI, and 46 (94 hip joints) had either bilateral FAI or ADDH. Therefore, eight (14.5%) patients with unilateral FAI had the absence of the contralateral FAI or ADDH (6.5% false-positive) despite the presence of ligamentum teres edema bilaterally, and the rest of the patients with bilateral ligamentum teres edema (102 joints: 92.7% positive predictive value) had findings of either FAI or ADDH. Conclusions Ligamentum teres edema can be considered as an early MRI marker to diagnose the underlying pathology of symptomatic painful hip disorders, especially FAI.