课件：髋关节Magnetic Resonance Imaging of the H.ppt

Figure 2. Prominence of the femoral head-neck junction in the anterior/anterosupeior portion of the proximal femur (white arrows) is known as the “pistol grip deformity” due to its similarities with the smooth hand grip appearance seen on many pistols. Linear contact Posterolateral ischial tuberosity Only 2 MRA revealed lig teres pathology * * * 腘绳肌腱 （Hamstring） 半膜肌 半腱肌+股二头肌 Hamstring Pathology MC site usually involves MT junction Focus on pathology to the PHAC to the ischial tuberosity Most severe injury avulsion Occurs in athletes during excessive eccentric contraction during running or jumping In children, the apophysis involved Hamstring Pathology Koulouris G, Connell D. Hamstring muscle complex: an imaging review. Radiographics 2005:25:571-586. Koulouris G, Connell D. Evaluation of the hamstring muscle complex following acute injury. Skeletal Radiol 2003:32:582-589. MR findings Most avulsions involve conjoint tendon with partial tearing of SMB Ragheb et al: 82% of pathology involved all 3 tendons SMB most common to be torn in isolation Treatment Early surgical intervention required To avoid complications such as gluteal sciatica from localized scarring or neuritis from displaced hamstrings Ligamentum Teres Increasingly recognized as a source of hip pain Function unknown: unlikely stability Proprioception Nocioception Spreading synovial fluid like a windshield wiper Ligamentum Teres Difficult to visualize on arthroscopy 3rd most common finding arthroscopically in athletes Deep anterior groin pain Gray et al described 3 types Complete rupture from trauma/surgery Partial tear in pts with chronic sx’s Degeneration in young pts RF’s include LCP and SCFE Gray et al. The ligamentum teres of the hip: an arthroscopic classification of its pathology. Arthroscopy 1997 Oct. Ligamentum Teres Byrd JWT et al. Traumatic rupture of the ligamentum teres as a souce of hip pain. Arthroscopy 2004. Treatment Debridement and washout Total hip arthroplasty performed when conse