舞者足踝损伤的影像学表现
本文综述舞者足踝损伤的影像学检查策略与特有表现,强调负重X线、负重CT、超声的应用指征,以及MRI作为金标准。重点识别舞者特有的病变,如拇长屈肌腱病、第二跖骨基底低风险应力性骨折和第五跖骨干螺旋形骨折。影像表现与症状、临床诊断的相关性对优化诊疗沟通至关重要。
要点
- 舞者足踝影像需优先负重X线,必要时负重CT评估应力性损伤。
- MRI为金标准,超声在特定指征下可辅助评估肌腱病变。
- 识别舞者特有损伤:拇长屈肌腱病、第二跖骨基底低风险骨折、第五跖骨干螺旋骨折。
核心结论
- 早期准确识别舞者特有的足踝影像表现对诊断至关重要,影像与临床症状的相关性影响诊疗决策。
- 了解舞者常见与少见损伤模式及其意义,可改善放射科与转诊医师的沟通,优化患者照护。
研究设计与样本
- 本文为综述性文章,讨论舞者足踝影像学的关键考虑,未报告系统检索范围、纳入文献数量或证据分级。
- 文中提及的影像方法包括负重X线、负重CT、超声和MRI,其中MRI被描述为金标准。
关键影像表现/征象
- 拇长屈肌腱病是舞者特有的肌腱病变,影像上可见肌腱异常。
- 第二跖骨基底低风险应力性骨折和第五跖骨干螺旋形骨折是舞者特有的骨折模式。
临床应用与阅片要点
- 对舞者足踝损伤,应优先采用负重X线,必要时使用负重CT评估应力性损伤。
- MRI通常为金标准,超声在特定指征下可应用。
- 阅片时需注意识别舞者特有的病变,如拇长屈肌腱病、第二跖骨基底低风险骨折和第五跖骨干螺旋骨折。
- 需理解影像表现与症状、临床诊断之间的相关性,以改善与转诊医师的沟通。
局限性
- 本文为综述,未报告系统检索策略、纳入文献数量及证据分级。
- 原文未报告具体研究设计、样本量或中心数。
以上解读依据论文摘要(全文未开放获取或许可不允许翻译转载)。
英文原文(摘要)· 点击展开
Dancers are performing artists and elite athletes with unique physiological and psychological demands. Many dance styles, especially classical ballet, require extraordinary flexibility and strength throughout the foot and ankle with remarkable pain tolerance. Injuries arising from biomechanical and metabolic stresses negatively impact career progression with resultant chronic pain, permanently impaired function, and financial loss. Therefore, dancers rarely seek medical attention except for genuine problems. The unique demands of dance can result in specific injuries and distinctive radiological patterns on imaging. Early and accurate recognition of these dance-specific findings is essential in diagnosing the dancer's foot and ankle. Given the dancer's unique needs and high risk of injury, this manuscript will discuss essential radiologic considerations specific to foot and ankle imaging in the dancer. Key points include the need for weightbearing radiographs, applications for weightbearing computed tomography, indications for ultrasound when magnetic resonance imaging is generally the gold standard, and the value of dancer-specific imaging techniques. An emphasis is placed on recognizing pathology that is genuinely unique to this patient cohort such as flexor hallucis longus tendinopathy, low-risk stress fractures at the second metatarsal base, and spiral fractures at the fifth metatarsal diaphysis. Understanding the degree of correlation between imaging findings with symptoms and clinical diagnoses is essential. Identifying common and uncommon injury patterns in dancers coupled with a knowledge of the implications of these injuries can facilitate improved communication with referring providers, which may help radiologists contribute to providing optimal patient care for a vulnerable patient population.
引用
- Colucci PG, Gao MA, Davenport KL, et al. Imaging findings of foot and ankle injuries in dancers. Skeletal Radiol. 2026. PMID: 42080902. doi:10.1007/s00256-026-05229-9
供执业医师工作参考,不替代临床判断;数值与分级以指南原文为准。