骶结节韧带部分损伤伴腘绳肌腱正常的MRI特征
本文报道3例运动相关的骶结节韧带中段损伤患者,腘绳肌腱正常,伴臀大肌拉伤。MRI显示骶结节韧带增厚、不规则,沿纤维及邻近臀大肌水肿,无骨水肿,肌腱正常。所有患者经休息和非甾体抗炎药治疗后好转。
要点
- 骶结节韧带损伤可表现为韧带增厚、不规则及纤维周围水肿,而无腘绳肌腱异常。
- 常伴臀大肌拉伤,阅片时需注意评估邻近肌肉水肿。
- 无骨水肿和肌腱正常有助于鉴别其他骨盆疼痛病因。
关键影像表现/征象
- 骶结节韧带增厚、不规则,沿纤维及邻近臀大肌水肿。
- 无骨水肿,腘绳肌腱正常。
- MRI可显示韧带起源、走行及与股二头肌和半腱肌腱的连续性。
临床应用与阅片要点
- 对于骨盆后部疼痛患者,应评估骶结节韧带,尤其是腘绳肌腱正常时。
- 注意寻找伴随的臀大肌拉伤征象。
- 韧带增厚和水肿而无骨水肿提示韧带损伤而非骨性病变。
局限性
- 样本量小(3例),缺乏对照组。
- 回顾性病例报告,证据等级较低。
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
The sacrotuberous ligament has an oblique course, from a broad fan-like origin in the posterior superior iliac spine, transverse tubercles of the sacrum and the upper part of the coccyx, descending laterally to attach to the medial surface of the ischial tuberosity. It provides stability to the pelvic girdle, including the sacroiliac joint, counterbalancing its rotation and limiting its movement. Magnetic resonance imaging (MRI) can identify this ligament, depicting its origin, course and continuity with the conjoined biceps femoris and semitendinosus tendon. However, there is no previous report of injuries to the midportion of this ligament, with normal hamstring tendons. In this article, we report three cases of sports-related sacrotuberous ligament injury, with normal hamstring tendons and associated with gluteus maximus muscle strain. MRI demonstrated thickening and irregularities of the sacrotuberous ligament, as well as edema along its fibers and in the adjacent gluteus maximus muscle, with no bone edema and normal tendons. All patients improved with rest and nonsteroidal anti-inflammatory medications.
引用
- Corrêa DG, Costa FM, Delazari TM, et al. Magnetic resonance imaging features of sacrotuberous ligament partial injury with normal hamstring tendons. Skeletal Radiol. 2026. PMID: 42142256. doi:10.1007/s00256-026-05256-6
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。