Role of MRT and USE in assessment of the knee structuresfor intra-articular fractures
Introduction. Modern diagnostic techniques, USE and MRT, allowing topical diagnosis used to reveal the knee diseases and injuries. Purpose. Complex examination performed in patients with the knee intra-articular fractures treated by fixation of fragments using the Ilizarov fixator under arthroscopic control. Materials and Methods. On admission all the patients underwent AP and lateral views of the knee radiography, and ultrasound examination (USE). Magnetic resonance tomography (MRT) performed in 12 patients using 1.5-T magnetic-resonance tomograph. Results. Trabecular edema of different manifestation revealed before treatment in seven patients, within a year after surgery – in five patients. The changes in medial and lateral menisci as inhomogeneity, destruction, partial or complete ruptures revealed by MRT technique in eight patients with closed intra-articular fractures of tibial upper third. The changes in ligamentous apparatus structure as inhomogeneity, swelling, thickening, partial or complete ruptures of ligaments revealed by MRT in nine patients. Conclusion. MRT technique allowed to obtain sufficient diagnostic information about all structural components of the joint: bone, cartilage, menisci. The data also evidence sufficiently high USE effectiveness to diagnose the knee changes postoperatively, and low effectiveness – in the acute period of trauma, that confirmed by the comparative evaluation of USE and MRT data. USE for intra-articular fractures before surgical treatment not recommended. In this period MRT technique is reasonable, which allows studying not only the character of the knee element injuries, but also the severity of bone structure and cartilage injury, to determine bone marrow condition.