背景:糖尿病(DM)伴周围神经病变(PN)导致足部畸形增加溃疡,关节脱位,截肢的风险。这项研究描述了有(DMPNMCD)和没有(DMPN-MCD)内侧柱畸形(MCD)的DMPN患者的足部和踝关节肌肉骨骼异常的频率和严重程度,以及它们与影像学检查对齐的关系。没有DMPN或MDC的年龄和体重指数匹配的对照。
方法:DMPN+MCD(n=11),DMPN-MCD(n=12),和对照组(n=12)进行了研究。一名放射科医生对足部和踝部磁共振图像(MRI)进行了肌腱/筋膜异常评分,韧带,肌肉,接头,和骨头。较高的分数代表较大的异常。从横向负重射线照片测量脚对齐。检查了联合组(n=35)中各组之间的异常频率以及异常与足部对齐之间的关系。
结果:DMPN+MCD有更高的总肌肉,接头,与对照组相比,骨评分和总关节评分高于DMPN-MCD。DMPN-MCD的总肌肉评分高于对照组。DMPN+MCD较高的骨和关节评分是由骨赘的频率增加所致,软骨损伤,局灶性骨髓水肿,新骨形成,和软骨下囊肿.显着相关性包括长方体高度和总骨和关节评分(分别为ρ=-0.37和ρ=-0.40)以及距骨倾角和总关节评分(ρ=0.38)。
结论:高对比分辨率MRI允许识别影响软骨表面的足结构病变,骨髓,DMPN+MCD患者的软组织支持。不出所料,MRI上骨和关节病变的存在与DMPN+MCD密切相关;令人惊讶的是,虽然样本很小,软组织支架的损伤与MCD无关.虽然MRI没有常规检查MCD,针对常见临床适应症进行MRI的信息的机会性使用可以允许早期识别与MCD相关的结构性病变并促进早期,积极的治疗。
方法:III.
BACKGROUND: Diabetes mellitus (DM) with peripheral neuropathy (PN) results in foot deformity increasing ulceration, joint dislocation, and amputation risk. This study describes the frequency and severity of foot and ankle musculoskeletal abnormalities and their relationship to radiographic alignment in people with DMPN with (DMPN + MCD) and without (DMPN - MCD) medial column deformity (MCD) compared to age- and body mass index-matched controls without DMPN or MDC.
METHODS: DMPN + MCD (n = 11), DMPN - MCD (n = 12), and controls (n = 12) were studied. A radiologist scored foot and ankle magnetic resonance images (MRI) for abnormalities in tendons/fascia, ligaments, muscles, joints, and bones. Higher scores represent greater abnormalities. Foot alignment was measured from lateral weightbearing radiographs. Frequency of abnormalities between groups and relationships between abnormalities and foot alignment in the combined group (n = 35) were examined.
RESULTS: DMPN + MCD had higher total muscle, joint, and bone scores compared to controls and higher total joint scores than DMPN - MCD. DMPN - MCD had higher total muscle scores than controls. DMPN + MCD higher bone and joint scores were driven by increased frequency of osteophytes, cartilage damage, focal bone marrow edema, new bone formation, and subchondral cysts. Significant correlations included cuboid height and total bone and joint scores (ρ = -0.37 and ρ = -0.40, respectively) and talar declination angle and total joint score (ρ = 0.38).
CONCLUSIONS: High contrast resolution MRI allowed identification of structural lesions of the foot affecting the cartilage surfaces, bone marrow, and soft tissue supports in patients with DMPN + MCD. As expected, the presence of bone and joint lesions on MRI were strongly associated with DMPN + MCD; surprisingly, although the sample is small, lesions of the soft tissue supports were not associated with MCD. While MRI is not done routinely to investigate MCD, opportunistic use of the information from MRI done for the common clinical indications may allow early identification of the structural lesions associated with MCD and facilitate early, aggressive therapy.
METHODS: III.