Li Xiongtao,Sun Jie,Wang Si,et al.Application of musculoskeletal ultrasound in acute lateral ankle sprain in children[J].Journal of Clinical Pediatric Surgery,2024,(11):1015-1018.[doi:10.3760/cma.j.cn101785-202409026-003]
肌骨超声在儿童急性踝关节扭伤中的应用
- Title:
- Application of musculoskeletal ultrasound in acute lateral ankle sprain in children
- Keywords:
- Ultrasound; Ligament Injury; Fracture; Surgical Procedures; Operative; Child
- 摘要:
- 目的 初步探讨肌骨超声检查诊断儿童急性踝关节扭伤的可靠性。方法 本研究为回顾性研究,纳入2023年10月至2024年8月于武汉儿童医院就诊的57例急性踝关节扭伤患儿作为研究对象。患儿均完成临床踝关节稳定性检查、踝关节肌骨超声检查、踝关节正侧位X线片和踝关节MRI检查。踝关节肌骨超声主要检查外踝撕脱骨折、距腓前韧带和跟腓韧带的完整性。以踝关节MRI检查结果为金标准,对比临床稳定性检查、踝关节肌骨超声检查、踝关节正侧位检查结果的可靠性。结果 踝关节稳定性检查诊断外踝韧带损伤的灵敏度为81%(17/21)、特异度为53%(19/36);踝关节肌骨超声检查诊断距腓前韧带损伤的灵敏度为95%(20/21)、特异度为94%(34/36),诊断跟腓韧带损伤的灵敏度为80%(4/5)、特异度为98%(51/52),诊断外踝撕脱骨折的灵敏度为96%(27/28)、特异度为83%(24/29);踝关节正侧位X线片诊断外踝骨折的灵敏度为39%(11/28)、特异度为100%(29/29)。结论 踝关节肌骨超声可以准确探查到被X线片漏诊的儿童外踝撕脱的软骨骨折块,也可以准确探查到外踝韧带损伤的情况。踝关节肌骨超声作为一种可靠、准确且无辐射的影像检查方法,可用于儿童急性踝关节扭伤的早期诊断。
- Abstract:
- Objective To preliminarily explore the reliability of musculoskeletal ultrasound in evaluating acute lateral ankle sprain in children. Methods This retrospective study included 57 children with acute ankle sprains who were treated at Wuhan Children’s Hospital between October 2023 and August 2024.All patients underwent clinical ankle stability tests,musculoskeletal ultrasound of the ankle,standard X-ray of the ankle in anterior-posterior and lateral views,and ankle MRI.Musculoskeletal ultrasound primarily assessed avulsion fractures of the lateral malleolus,and the integrity of the anterior talofibular and calcaneofibular ligaments.Using MRI as the gold standard,the reliability of clinical stability tests,musculoskeletal ultrasound,and standard X-rays were compared. Results The sensitivity and specificity of the clinical stability test in assessing lateral ankle ligament injury were 81% (17/21) and 53% (19/36),respectively.Musculoskeletal ultrasound had a sensitivity of 95% (20/21) and specificity of 94% (34/36) for assessing anterior talofibular ligament injury,a sensitivity of 80% (4/5) and specificity of 98% (51/52) for calcaneofibular ligament injury,and a sensitivity of 96% (27/28) and specificity of 83% (24/29) for lateral malleolus avulsion fractures.Standard X-ray had a sensitivity of 39% (11/28) and specificity of 100% (29/29) in detecting lateral malleolus fractures. Conclusions Musculoskeletal ultrasound can accurately detect cartilaginous avulsion fractures of the lateral malleolus that may be missed by X-rays,as well as injuries to the lateral ankle ligaments.As a reliable,accurate,and radiation-free imaging method,musculoskeletal ultrasound can be used for early diagnosis of acute ankle sprains in children.
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备注/Memo
收稿日期:2024-9-9。
基金项目:武汉市卫健委科研项目(WX23A10);武汉儿童医院“腾飞计划”临床研究类项目(2023TFJH01)
通讯作者:沈先涛,Email:xiantaoshen9815@aliyun.com