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

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.

Anahtar Kelimeler:

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

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

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,

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