小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 膝关节肿胀
- 感到膝关节不稳定或屈曲/交锁
- 膝关节疼痛
- 关节线触痛和关节线捻发音
- McMurray试验阳性
- Apley试验阳性
- 过伸试验阳性
其他诊断因素
- 慢性病例中的腘窝囊肿(贝克囊肿)
- 关节活动度受限
危险因素
- 急性外伤(扭伤)
- 膝关节炎
- 膝关节不稳定
- 前交叉韧带损伤史
- 膝关节对线差
- 粗糙或不平坦的运动场地
- 较差的地面或天气条件
- 建筑工人和体力劳动者
- 盘状半月板
诊断性检查
首要检查
- MRI 扫描
- X光平片:前后位(AP)X光片、外侧膝关节X光片、45度PA屈曲和水平线视图
需考虑的检查
- 关节镜检查
治疗流程
所有患者
撰稿人
作者
Hideki Takeda, MD
Orthopedic Surgeon
Department of Sports Orthopedics
NTT Medical Center Tokyo
Tokyo
Japan
利益声明
HT declares that he has no competing interests.
鸣谢
Dr Hideki Takeda would like to gratefully acknowledge Dr Lars Engebretsen and Dr Kevin R. Stone, previous contributors to this topic. LE declares that he has no competing interests. KRS is an author of several references cited in this topic.
同行评议者
Daniel Solomon, MD
Co-Director of Orthopedic Sports and Shoulder Service
Department of Orthopedic Surgery
Naval Medical Center San Diego
San Diego
CA
利益声明
DS declares that he has no competing interests.
Jung-Ro Yoon, MD
Orthopedic Surgeon
Department of Orthopedic Surgery
Seoul Veterans Hospital
Seoul
South Korea
利益声明
JRY declares that she has no competing interests.
鉴别诊断
- 前交叉韧带撕裂
- 内侧副韧带拉伤
- 后交叉韧带扭伤
更多 鉴别诊断指南
- 关节镜半月板手术:国家学会治疗指南和共识声明
- 关于膝关节半月板病变的定义、检查和分类的国家共识
更多 指南患者教育信息
Osteoarthritis
更多 患者教育信息登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明