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[ 會員#14208 ] jobylww

膝關節有什麼損傷?

病患者男 - 42.5歲

半年前因為跑步,左膝在屈膝上落樓梯,某個角度就會痛,於是去了照MRI,得出以後結果:

Findings
The knee alignment is normal. There is minor joint fluid. No popliteal cyst is noted

There is abnormal signal on T2FS images in the distal medial femoral condyle due to bone oedema / bruises. This is associated with cartilage loss due to osteochondral lesion (OCL)

The anterior cruciate ligament is thickened. The fibres are still well defined. There is no loss of continuity of the fibres. These are due to a sprain. The posterior cruciate ligament is redundant and the fibres remain intact. No tears is seen.

There is abnormal signal with thinning of the lateral facet patellar articular cartilage. This is seen down to the patellar bone due to Grade 3 / 4 chondromalacia.

On T2* and PD images, there is abnormal meniscal signal seen in the posterior horn of the medial meniscus due to degeneration. No definite tear.

There is no abnormality detected in the medial and 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 unremarkable.

Comment
1. Minor joint fluid.
2. Bone oedema distal medial femoral condyle with OCL
3. Sprain ACL
4. Chondromalacia
5. Degenerative signal in the posterior horn of the medial meniscus. No definite tear.

想問骨科專科醫生,我的傷勢如何?要做什麼治療才可以?
Jobylww 你好,

從這份磁力共振報告的描述,有兩個主要問題,第一是膝蓋上方,即是股骨的內側有軟骨缺陷(osteochondral lesion),第二是髕骨(patella),即俗稱菠蘿蓋的地方,出現了頗厲害的軟骨勞損。幸好的是,前十字韌帶和半月板只有小問題,沒有明顯的撕裂。

看你在上落樓梯時,某個角度會出現痛,我建議你要找一位骨科醫生,作一個詳細的臨床檢查,檢查痛的位置和原因,是以上兩個問題中那一個導致的,才對症下藥。

一般來說,如果軟骨缺陷嚴重,首先要了解軟骨缺陷的大小,作出相對應的處理,可以進行微創膝關節手術去解決問題。

後者髕骨軟骨勞損,便要從日常生活開始注意,維持適當的體重,多做肌肉的強化運動,減少做一些有機會再令膝關節勞損的運動和事情,口服葡萄糖胺也對一部份患者有幫助,如情況不改善,注射透明質酸是現在越來越普及的方法,可以有效減低軟骨勞損後,關節磨擦造成的痛楚。

詳情請向骨科醫生查詢及商量解決的方法。謝謝你的提問,有問題請再提出!

祝你早日找出原因和根治的方法!

劉新榮醫生上
以上資料只供參考,不能作診症用途,
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