슬관절 외상 후 자기 공명 영상에서 관찰되는 잠재성 골 병변과 동반 손상과의 관계

The Relationship between Bone Bruise in MRI and Associated Injuries after the Knee Joint Trauma

목적 : 슬관절의외상후자기공명영상에서관찰되는잠재성골병변과동반손상과의관계를손상에너지의정도에따라알아보고자하였다. 대상및방법 : 슬관절의외상을받은50예의환자들을대상으로2군으로나누었으며교통사고등고에너지손상을받은제I군은13예, 스포츠손상등저에너지손상을받은제II군은37예였다. 골병변은Costa-Paz의분류상제1,2,3형으로구분하였으며, 위치에따라대퇴골/경골, 내과/외과, 전/중/후로나누어동반손상과의관계를분석하였다. 결과 : 제 I군에서는슬관절내의병변의위치분포는호발부위없이고른분포를보였고전방십자인대손상과골병변만이존재하는경우가각각38$\%$씩으로나타났고, 제1형(52.6$\%$)이가장흔한형태였다. 제 II군에서는대퇴골외과의중간부위와경골외과의후방부위에호발하였으며, 전방십자인대손상이56.8$\%$, 다음으로는내측반월상연골이24.3$\%$로나타나차이를보였으며, 제2형(48$\%$), 제1형( 42$\%$)의순으로나타났다. 결론 : 고 에너지 손상에서는 골 병변의 위치는슬관절에 가해진 손상 방향에 따라분포가 다양하였고, 저 에너지 손상에서는 특정 부위에호발되는경향을보여 스포츠손상등 저 에너지손상에서는손상기전에따른동반손상과 골병변의위치가관련이있음을짐작케하나좀더많은증례로분석이필요할것으로사료된다.

Purpose : The purpose is to analyze the relationship between bone bruise in MRI and associated injuries after the knee joint trauma. Materials and Methods : Total 50 cases were reviewed, divided into two groups according to initial trauma energy. High-energy group (group I), such as traffic accident was 13 cases, low-energy group (group II), such as sports trauma was 37 cases. The type of the lesion was used the classification by Costa-Paz. The site of lesion was analyzed according to femoral/tibial, medial/lateral and anterior/middle/posterior site respectively. Associated injuries were confirmed by physical examination, radiograph, MRI and arthroscopy. Results : In group I there was a various distribution of the bone bruise in the knee joint according to mechanism of injury. The bone bruise with ACL injury was 38$\%$ only and the most frequent type was Costa-Paz type I (52.6 $\%$). In group II more frequent locations were the middle portion of the lateral femoral condyle and the posterior portion of the lateral tibial condyle. Bone bruise associated with ACL injury, was upto 56.8 $\%$ and the frequent type were Costa-Paz type II (48 $\%$), in order type I (42 $\%$). As a result, in the high-energy injury the bone bruise had a various location in both condyle and less frequently associated injury, but in the low-energy injury there was particularly frequent location of bone bruise, associated injury and type. Conclusions : We could assess the associated injury by analysis of the location and type of bone bruise, especially in the low-energy injury, e.g. sports injury. But further study will be necessary with more case analysis.