Ayağın Ağrılı Kemik ve Kemikcikleri

Travmatik kırık-kontüzyon ve avasküler nekroz (AVN) ayak ağrısının en önemli nedenleri arasındadır. Ayak kemiklerinde AVN sık rastlanmakla birlikte, aksesuar kemiklerde görülmesi durumunda klinik ve radyolojik olarak tanısal güçlüklere yol açabilmekte ve yanlış olarak kırık tanısı alabilmektedir. Aksesuar kemiklerin lokalizasyonlarının bilinmesi ayırıcı tanıda oldukça önemlidir. Bu makalede ayak kemik ve aksesuar kemikçiklerinde avasküler nekroz ve travmaya ikincil kırık-kontüzyon olguları ile sık rastlanan ağrılı kemik sendromlarının manyetik rezonans görüntüleme (MRG) bulguları sunulmakta ve oluşturdukları tanısal güçlükler tartışılmaktadır.

Painful Bones and Accessory Bones of The Foot

Traumatic contusion-fractures and avascular necrosis are the most important reasons of foot pain. Although avascular necrosis of the foot bones is a common occurrence, in case of involvement of the accessory bones, the clinical and radiological diagnosis is difficult and may simulate fractures. Thus, it is important to know the locations of the accessory bones for differential diagnosis. This study has presented and discussed the magnetic resonance imaging findings and diagnostic difficulties of avascular necrosis and contusion-fractures secondary to trauma of the foot bones, sesamoid bones, and accessory bones.

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  • 1. Berquist TH: MRI of the Musculoskeletal System. Pelvis, Hips and Thigh. Osteonecrosis. Lippincott Williams & Wilkins Philadelphia, 2001, P:241-254.
  • 2. Yochum T, Rowe LJ. Essentials of Skeleteal Radiology. Hematological and Vascular Disease of the Bone. Williams & Wilkins Utah, 1987, P:978-83.
  • 3. Berquist TH. MRI of the Musculoskeletal System. Foot, ankle and calf. Ischemic Bone and Soft Tissue Diseases. Lippincott Williams & Wilkins Philadelphia, 2001, P:567-71.
  • 4. Zehava S. Rosenberg, MD, Javier Beltran, MD and Jenny T. Bencardino. MR Imaging of the Ankle and Foot.Radiographics. 2000;20:153-79 . 5. Stoller DW, Tirman PFJ, Bredalla MA. Diagnostic Imaging Orthopaedics. Navicular Fractures. Amirsys Baltimore. 2004, Section 6, P:6-74.
  • 6. Logan PM, Connell GD. Painful os cuboideum secundarium. Cross-sectional imaging findings. J Am Pediatr Med Assoc. 1996; 86:123-5.
  • 7. Gaulke R, Schmitz H. Free os cuboideum secundarium: A case report. Journal of Foot and Ankle Surgery. 2003; 42:230-4.
  • 8. Stoller DW, Tirman PFJ, Bredalla MA. Diagnostic Imaging Orthopaedics. Sesamoid dysfunction. Amirsys Baltimore, 2004, Section 6, P:114-117.
  • 9. Taylor J, Sartoris D, Huang G, Resnick D. Painful Conditions Affecting the First Metatarsal Sesamoid Bones. Radiographics. 1993;13:817-30.
  • 10. Berquist TH. MRI of the Musculoskeletal System. Foot, ankle nad calf. Os Trigonum Syndrome. Lippincott Williams & Wilkins Philadelphia, 2001, P:537.
  • 11. Stoller DW, Tirman PFJ, Bredalla MA. Diagnostic Imaging Orthopaedics. Os Trigonum Syndrome. Amirsys Baltimore, 2004, Section 6, P:106-109.
  • 12. Karasick D, Schweitzer ME. Os Trigonum Syndrome: Imaging Features. AJR. 1996;166:125-9.
  • 13. Stoller DW, Tirman PFJ, Bredalla MA. Diagnostic Imaging Orthopaedics. Freibergs İnfarction. Amirsys Baltimore, 2004, Section 6, 94-97.
  • 14. Ashman C, Klecker RJ, Yu JS. Forefoot pain Involving the Metatarsal Region. Radiographics. 2001;21:1425-40.
  • 15. Stoller DW, Tirman PFJ, Bredalla MA. Diagnostic Imaging Orthopaedics. Accesory Navicular. Amirsys Baltimore, 2004, Section 6,110-113.
  • 16. Miller TT, Staron RB. The Symptomatic Accessory Tarsal Navicular Bone: Assessment with MR Imaging. Radiology. 1995;195:849-53