Ayak Bileği İmpingement Sendromu Olgularında Direkt Grafi ve Manyetik Rezonans Görüntüleme Bulgularının Kontrol Grubu ile Korelasyonu

Year 2018, , 922 - 938, 15.08.2018

Halime Çevik , Necip Bülend Saydam

https://doi.org/10.30569/adiyamansaglik.434533

Abstract

Amaç: Ayak bileği
impingement sendromu (ABİS), genellikle gerilme veya travma sonrası,
profesyonel atletlerde ve gençlerde aktivite sırasında gelişen kronik ağrıyla
karakterizedir.  Ağrının nedeni tibia ile
talus arasında yumuşak doku veya kemiğin sıkışmasıdır. Çalışmamızın amacı, ABİS
olgularında osteofitlerin gösterilmesinde direkt grafi (DR) ve Manyetik
Rezonans Görüntüleme (MRG)’nin etkinliğinin karşılaştırılmasıdır. Ayrıca
tibiotalar ve talonaviküler eklem değişiklikleri araştırılmıştır.

Gereç ve
Yöntem:  Çalışmamız retrospektiftir. Mayıs
2004-Şubat 2006 tarihlerinde, Fatih Sultan Mehmet Eğitim ve Araştırma Hastanesi
Radyoloji Kliniği’ne, ABİS tanısıyla radyolojik tetkik istemi yapılmış 28
hastaya ait 30 ayak bileği ile kontrol grubu olarak ABİS tanısı olmayan 20
hastanın 20 ayak bileği dahil edildi. 
Olgulara anteriorposterior (AP) ve lateral DR ile MRG incelemesi
yapılmıştır.

Bulgular: DR’de osteofit
lokalizasyon dağılımları istatistiksel farklılık göstermekte (p<0,05) olup,
anterolateral ve posteriorda görülme oranı ABİS grupta yüksekti. MRG’de ABİS’de
%83 ve kontrol grubunda %35 osteofit saptandı. MRG’de osteofit dağılımları
gruplara göre anlamlı farklılık göstermekte (p<0,01) olup, anterolateral
osteofitlerin tamamı ABİS olgularında görüldü. Kontrol grubunda osteofit
görülme oranı düşüktür. ABİS’de osteofit lokalizasyonları, DR ile MRG
karşılaştırıldığında, istatistiksel olarak anlamlı ilişki gözlendi
(r:0,779;p<0,01). ABİS’de talonaviküler ve tibiotalar eklemlerde, kontrol
grubunda ise sadece talonaviküler eklemde osteoartroz bulguları saptandı.

 Sonuç: Çalışmamızda ABİS olgularında MRG, DR’e
göre osteofit saptanması ve lokalizasyonlarını göstermede daha etkili
bulunmuştur. Prognozu belirleyen tibiotalar eklem artrozu MRG erken evrede
saptanabilmektedir. Buna göre, ABİS erken tanı ve tedavisinde MRG katkı
sağlamaktadır.  

Keywords

Ayak bileği, impingement sendromu, Manyetik Rezonans Görüntüleme, Direkt Radyografi

Correlatıon Between Direct Graph And Magnetic Resonance Imaging of Control Group and Ankle Impıngement Syndromes

Abstract

Aim: Impingement syndromes (ABIS) are
characterized by chronic pain, during activity in professional athletes and
young people. The cause of the pain ABIS the compression of soft tissue or bone
between the tibia and the talus. The aim of our study ABIS to compare the efficacy
of direct radiographs (DR) and magnetic resonance imaging (MRG) examinations in
revealing osteophytes in cases with ABİS. Tibiotalar and talonavicular joint
changes in the case of ABİS were investigated.

Material-Method: The study
was retrospectively at Fatih Sultan Mehmet Training and Research Hospital
Radiology Clinic. The study was included 30 ankles of 28 patients who were
diagnosed with ABİS and a control group of 20. The ankles were subjected to MRG
examination with standard AP and lateral DR.

Results: In DR, distribution
according to osteophyte localizations showed statistically difference (p<0.05);
the incidence of anterolateral and posterior localization was higher in the ABIS
group.In MRG; of impingement group (83%) and control group (35%) osteophytes
were observed. The distribution of osteophyte localizations on MRG, showed a
statistically difference between the groups (p<0,01). All cases of
anterolateral localizations are observed in the patient group. When DR and MRG
were compared and the relationship status between the osteophyte localisation
were examined in the impingement group, a statistically relationship was
observed (r:0,779;p<0,01). Findings of osteoarthros ABİS were observed in
the talonavicular and tibiotalar joint of impingement; only talonavicular joint
in the control group.

Coclusion: MRG
was found to be more effective than DR, in detecting and localizing osteophytes
in cases with ABİS. The tibiotalar joint arthrosis that determines the prognos
ABİS is detected early stage by MRG, increasing the possibility of treatment in
ABİS. Accordingly, ABIS provides early diagnosis and treatment of
MRI.

Keywords

Ankle, impingement, Magnetic Rezonance Imaging, Radiography

References

• 1. Henderson I, Valette DL. Ankle İmpingement: Combined Anterior and Posterior İmpingement Sydrome of the Ankle. Foot Ankle Int. 2004 Sep;25(9):632-8.
• 2. Tol JL; Verhagen RAW; Krips R et al. The Anterior Ankle İmpingement Syndrome: Diagnostic Value of Oblique Radiographs. Foot Ankle İnt 2004 Feb;25(2): 63-68.
• 3. Robinson P, White LM, Salonen DC, et al. Anterolateral Ankle İmpingement: MRI Arthrographic Assessment of the Anterolateral Recess. Radiology 2001; 221(1); 186-190. 4. Farooki S, Yao L, Seeger LL. Anterolateral İmpingement of the Ankle: Effectiveness of MRI İmaging. Radiology 1998; 207: 357-360. 5. Robinson P, White LM. Soft-Tissue and Osseous İmpingement Syndromes of the Ankle: Role of Imaging in Diagnosis and Management. Radiographics 2002; 22(6);1457-1471.
• 6. Stoller DW. Magnetic Resonance Imaging in Orthopaedics and Sports Medicine 1997.
• 7. Rosenberg ZS, Beltran J and Bercardino JT. MRI İmaging of the Ankle and Foot.Radiographics, 2000; 20; S153- S179. DOI:10.1148/radiographics.20.suppl_1.g00oc26s153
• 8. Cerezal L, Abascal F, Canga A, et al. MRI İmaging of Ankle İmpingement Syndromes. AJR Am J Roentgenol. 2003 Aug;181(2):551-559. 9. Tol JL, Verheyen CPPM, Van Dijik CN. Artroscopic treatment of anterior impingement in the ankle; a prospective study with a five to eight year follow up. J Bone Joint Surg Br 2001; 83(1); 9-13.
• 10. Schweitzer ME, Leersum M, Erhlich SS et al. Fluid in Normal and Abnormal Ankle Joints: Amount and Distributions as seen on MRI images. AJR Am J Roentgenol. 1994 Jan;162(1):111-4.
• 11. 11. Schwitzer ME, Magbalon MJ, Fenlin JM et al. Effusion Criteria and Clinical Importance of GlenohuMRIeal Jonint Fluid: MRI Imaging Evolution. Radiology. 1995 Mar;194(3):821-4.
• 12. 12. Tol JL, van Dijk CN. Etiology of the Anterior Ankle İmpingement Sydrome: A Descriptive Anatomical Study. Foot Ankle Int. 2004 Jun;25(6):382-6. 13. Donald Resnick. Talar Ridges, Osteophytes and Beaks: A Radiologic Commentary. Radiology. 1984 May;151(2):329-32.
• 14. Berberian WS, Hecht PJ, Wapner KL et al. Morphology of Tibiotalar Osteophytese in Anterior Ankle İmpingement. Foot Ankle Int. 2001 Apr;22(4):313-7.
• 15. Bureau NJ, Cardinal E, Hobden R, et al. Posterior Ankle İmpingement Syndrome: MRI İmaging Findings in Seven Patients. Radiology. 2000;215(2):497-503.
• 16. Lee JW, Suh JS, Huh YM, et al. Soft Tissue İmpingement Syndrome of the Ankle: Diagnostic Efficacy of MRII and Clinical Results after Artroscopic Treatment. Foot Ankle Int. 2004 Dec;25(12):896-902.
• 17. Umans H. Ankle impengement syndromes. Semin Musculoskelet Radiol. 2002 Jun;6(2):133-39.
• 18. Liu SH, Raskin A, Osti L, et al. Arthroscopic teatment of anterolateral ankle impingement. Arthroscopy. 1994 Apr;10(2):215-8.
• 19. Masciocchi C, Catalucci A, Barile A. Ankle İmpingement Syndromes. Eur J Radiol. 1998 May;27 Suppl 1:S70-3. PM
• 20. Ferkel RD and Fischer SP. Progress in ankle arthroscopy. Clin Orthop Relat Res. 1989 Mar;(240):210-20. 21. Liu SH, Raskin A, Osti L, et al. Arthroscopic treatment of ankle impingement. Arthroscopy. 1994 Apr;10(2):215-8.
• 22. Beynnon BD, Murphy DF, Alosa DM. Predictive Factors for Lateral Ankle Sprains: A Literature Review. J Athl Train. 2002 Dec;37(4):376-380. 23. Stoller SM, Hekmat F, Kleiger B. A comparative study of the ferquency of anterior impingement exostoses of the ankle in dancers and nondancers. Foot Ankle. 1984. Jan-Feb; 4(4); 201-3. Foot Ankle. 1984;4(4):201-3.
• 24. Peterfy CG, Guermazi A, Zaim S, Tirman PF, Miaux Y, White D, et al. Whole-Organ Magnetic Resonance Imaging Score (WORMS) of the knee in osteoarthritis. Osteoarthritis Cartilage 2004.
• 25. John S, Mendicino RW, Catanzariti AR. Mastering Ankle Impinegement Syndromes. Podiatry Today. 2007.20 (8);52-60.