[ 會員#20306 ] CHAU CHUN SING
正確的治療方法?
病患者男 - 34歲
CLINICAL HISTORY:
Injury left knee.
Sensation of click.
Lateral + medial tenderness.
MRI Report
FINDINGS:
the knee alignment is normal, there is moderate joint effusion with superior plica.
no popliteal cyst is noted. increased signal seen in the infra-patellar fat pad due to synovitis. some fluid is seen between the inferior patellar tendon and anterior tibial tubercle due to deep bursitis.
there is soft tissue swelling seen medially and involves the medial collateral ligament and is compatible with a grade 1 sprain.
increased signal along the ilio-tibial tract and also between the ilio-tibial tract and lateral femoral condyle compatible with ilio-tibial band syndrome.
there is abnormal signal without thinning of the mid facet patellar articular cartilage.this is due to grade I chondromalacia.
there is no abnormal signal on T2 FS images in the femur, tibia and fibula to suggest fracture or bone oedema / bruises.
on T2* and PD images, there is no abnormal meniscal signal.
The anterior and posterior cruciate ligmaents outline normally. The fibres are well visualized especially on T2 FS images. No evidence of discontinuity. No tear is detected.
there is no abnormality detected in the lateral collateral ligaments. No soft tissue swelling or oedema is seen. No tear is detected.
the patella is normal in position. there is no dislocation. the quadriceps and the inferior patellar tendon are unnremarkable.
COMMENT:
1. moderate joint effusion with superior plica.
2. Sprain MCL.
3. Ilio-tibial band syndrome.
4. Chondromalacia.
本人想提問醫生正確的治療方法? 謝謝。
CLINICAL HISTORY:
Injury left knee.
Sensation of click.
Lateral + medial tenderness.
MRI Report
FINDINGS:
the knee alignment is normal, there is moderate joint effusion with superior plica.
no popliteal cyst is noted. increased signal seen in the infra-patellar fat pad due to synovitis. some fluid is seen between the inferior patellar tendon and anterior tibial tubercle due to deep bursitis.
there is soft tissue swelling seen medially and involves the medial collateral ligament and is compatible with a grade 1 sprain.
increased signal along the ilio-tibial tract and also between the ilio-tibial tract and lateral femoral condyle compatible with ilio-tibial band syndrome.
there is abnormal signal without thinning of the mid facet patellar articular cartilage.this is due to grade I chondromalacia.
there is no abnormal signal on T2 FS images in the femur, tibia and fibula to suggest fracture or bone oedema / bruises.
on T2* and PD images, there is no abnormal meniscal signal.
The anterior and posterior cruciate ligmaents outline normally. The fibres are well visualized especially on T2 FS images. No evidence of discontinuity. No tear is detected.
there is no abnormality detected in the lateral collateral ligaments. No soft tissue swelling or oedema is seen. No tear is detected.
the patella is normal in position. there is no dislocation. the quadriceps and the inferior patellar tendon are unnremarkable.
COMMENT:
1. moderate joint effusion with superior plica.
2. Sprain MCL.
3. Ilio-tibial band syndrome.
4. Chondromalacia.
本人想提問醫生正確的治療方法? 謝謝。
陳禮樂醫生回覆: [ 9/19/2018 ]
您好，多謝讀者你的來信。
膝關節皺褶（Knee joint plica syndrome）病變好發於長跑、自行車、階梯運動等這些必須重複彎曲-伸直膝蓋的運動員，但也常於交通事故的患者身上發現。膝關節皺褶病變起因於長期與關節軟骨相互摩擦，引起炎性反應（滑液囊發炎、膝關節腫脹），影響到關節功能性表現；長時間炎症無法解除會造成皺褶纖維化及增厚，甚至導致關節軟骨之磨損與退化。臨床理學檢查可發現膝關節有局部性的壓痛，膝關節彎曲時，會感覺到有喀喀聲響出現。另外，將髕骨推往外側時，會因為內側皺褶的張力變大，而誘發出更明顯的症狀。對於膝關節皺褶（Knee joint plica syndrome）處理原則：
（1）急性發作遵循PRICE運動傷害處理原則，應適當休息。
（2）炎症反應藉由保守療法即可得好良好的控制（超音波治療、手法治療）。
（3）運動的熱身/收操應加強膝關節周邊肌群的伸展運動。
（4）情況無法改善應考慮關節鏡手術的必要性。
祝生活愉快
膝關節皺褶（Knee joint plica syndrome）病變好發於長跑、自行車、階梯運動等這些必須重複彎曲-伸直膝蓋的運動員，但也常於交通事故的患者身上發現。膝關節皺褶病變起因於長期與關節軟骨相互摩擦，引起炎性反應（滑液囊發炎、膝關節腫脹），影響到關節功能性表現；長時間炎症無法解除會造成皺褶纖維化及增厚，甚至導致關節軟骨之磨損與退化。臨床理學檢查可發現膝關節有局部性的壓痛，膝關節彎曲時，會感覺到有喀喀聲響出現。另外，將髕骨推往外側時，會因為內側皺褶的張力變大，而誘發出更明顯的症狀。對於膝關節皺褶（Knee joint plica syndrome）處理原則：
（1）急性發作遵循PRICE運動傷害處理原則，應適當休息。
（2）炎症反應藉由保守療法即可得好良好的控制（超音波治療、手法治療）。
（3）運動的熱身/收操應加強膝關節周邊肌群的伸展運動。
（4）情況無法改善應考慮關節鏡手術的必要性。
祝生活愉快
以上資料只供參考，不能作診症用途，
請與家庭醫生查詢並作出適合治療。
如有身體不適請即求診，切勿延誤治療。
若資料有所漏誤，本網及相關資料提供者恕不負責。
請與家庭醫生查詢並作出適合治療。
如有身體不適請即求診，切勿延誤治療。
若資料有所漏誤，本網及相關資料提供者恕不負責。
其他陳禮樂醫生醫務信箱回覆Elsa : 手踭跌傷4個月後仍然痛
病患者女 - 47歲 你好，本人於4個月前跌傷左手踭，照了 x-ray 及MRI, 醫生都説手踭沒骨折及.......: 手同舌頭麻痺
病患者女 - 47歲 3年前有頸椎問題，一直有睇脊醫，已停止睇半年，17/7開始有感冒食過西醫中醫唔得，.......Chan Mo Ching : 胸骨折斷
病患者男 - 89歲 本人的父親最近腰部很痛, 吃了止痛藥也無太大效用, 主要是起床時及臥床均十分吃力及.......May Tsr : 手錚發炎，骨膜水腫
病患者女 - 53歲 由於我經常不小心撞傷手錚，導致手錚發炎，骨膜內有水腫，經MRI報告講出來，十分痛楚.......Yeung Suk Ting : 右腳內踝足主力骨(tibia)尾骨折
病患者女 - 22歲 應該咁講我嗰個情況就係 右腳內踝足主力骨(tibia)尾骨折 但無骨碎 有3mm.......So Hong : 三七步
病患者男 - 23歲 您好，陳禮樂醫生 長期三七步站姿會影響小朋友發育嗎？例如長短腳或骨盆歪斜等等。甚.......Siu Zoey : 照盤骨X-ray發現右邊有囊腫
病患者女 - 30歲 坐骨神經痛去左照X-ray ，照到盤骨位發現右邊有囊腫。 應該要睇咩科？囊腫係咩.......J121 : 腫痛
病患者女 - 85歲 早前膝頭哥痛， 去過針灸，食過中藥第三次開始右邊頸椎痛，食完第四次，右邊好返到左邊.......Belle : 腳痛
病患者女 - 33歲 腳腕内側好痛,是甚麼原因? 如何舒緩或治療?.......Ms Wong : 脛椎間盤
病患者女 - 52歲 你好! 請問患脛椎間盤突出應看甚麼專科? 謝謝!....... 發出提問使用細則
致陳禮樂醫生 提問
即時提問 ?
