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Erschienen in: Der Radiologe 5/2018

26.01.2018 | Knorpelverletzungen des Kniegelenks | Leitthema

Dezidierte Knorpelbildgebung zur Detektion von Knorpelverletzungen und osteochondralen Läsionen

verfasst von: Dr. med. A. S. Gersing, Dr. med. B. J. Schwaiger, Prof. Dr. med. K. Wörtler, PD. Dr. P. M. Jungmann

Erschienen in: Die Radiologie | Ausgabe 5/2018

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Zusammenfassung

Hintergrund

Osteochondrale Läsionen stellen einen Hauptrisikofaktor für die Entwicklung einer Arthrose am Sprunggelenk dar.

Ziel

Es sollen ein Überblick über therapierelevante klinische Bildgebungsverfahren zur Knorpelbildgebung an Fuß und Sprunggelenk gegeben und typische osteochondrale Verletzungen demonstriert werden.

Material und Methoden

Eine intensive Literaturrecherche wurde durchgeführt und mit persönlicher Erfahrung unterstrichen.

Ergebnisse

Die Knorpelbildgebung zur Detektion osteochondraler Läsionen an Fuß und Sprunggelenk bleibt eine Herausforderung. Dennoch können dezidierte morphologische und quantitative magnetresonanztomographische (MR-)Bildgebungsmethoden klinisch wichtige Informationen zur Verfügung stellen, die hilfreich bei Therapieentscheidungen z. B. hinsichtlich einer knorpelchirurgischen Maßnahme sind. Die Sensitivität der MR-Arthrographie (MR-A) und computertomographischen Arthrographie (CT-A) ist der nativen Magnetresonanztomographie (MRT) bezüglich der Detektion osteochondraler Läsionen überlegen. Im Bereich der kleineren Gelenke des Fußes werden vor allem fortgeschrittene degenerative Veränderungen mittels konventioneller Röntgendiagnostik detektiert; nur in ausgewählten Fällen spielt die MR- und CT-Diagnostik dieser kleineren Gelenken eine Rolle.

Diskussion

Während die dezidierte Knorpelbildgebung mit CT und MRT im Bereich der kleinen Fußgelenke eine geringere Rolle spielt, wird sie im Bereich des Sprunggelenks aufgrund der verfügbaren therapeutischen Optionen wie verschiedenen knorpelchirurgischen Verfahren immer wichtiger für die klinische Diagnostik.
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Metadaten
Titel
Dezidierte Knorpelbildgebung zur Detektion von Knorpelverletzungen und osteochondralen Läsionen
verfasst von
Dr. med. A. S. Gersing
Dr. med. B. J. Schwaiger
Prof. Dr. med. K. Wörtler
PD. Dr. P. M. Jungmann
Publikationsdatum
26.01.2018
Verlag
Springer Medizin
Erschienen in
Die Radiologie / Ausgabe 5/2018
Print ISSN: 2731-7048
Elektronische ISSN: 2731-7056
DOI
https://doi.org/10.1007/s00117-017-0348-2

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