I-Knee

I-Knee | I-MRI ingacelwa ukuba:

• Ukulimala kweLigament
• Iintsizi kunye nehlazo
• Irheumatoid arthritis
• I-Osteochondral fractures
• Ukuphazamiseka kweTendon

Amathambo kunye neKartilage yamaDolo

Ixolo elidityanisiweyo lilo likhulu kakhulu, linzima kakhulu, kwaye lincinci lihlangene emzimbeni, njengoko lingenanto yokucwangcisa. Iqulethwe ngumbhalo we-tibiofemoral kunye ne-patellofemoral, equka i-femur, tibia kunye ne patella. Ibhokisi lihlangene ne-synovial edibene ne-capsule ye-ligament. I-capsule iqukethe i-synovial fluid egcina idibeneyo igcwele (Umfanekiso 82). Ibhokisi linika ukunyakaza okuguquguqukayo, kodwa kufuneka kuthwale ubunzima obukhulu kunye noxinzelelo. Ngexesha lokuhamba, amadolo axhasa amaxesha e-1.5 ubunzima bomzimba wakho. Xa ukhuphuka izitebhisi, zixhasa ii3-4 amaxesha akho ubunzima bomzimba. Xa ugxuma, amadolo akho axhasa ama8 amaxesha akho ubunzima bomzimba.

Ingqungquthela ye-tibiofemoral yintsebenziswano echitshiweyo evumela ukuguqa nokulungiswa, kodwa ivumela ukujikelezwa okufutshane. Le ngqungquthela iqulethe i-conditional and medial condyles ye-femur yokuphumla kwimimandla engaphaya kwimihlaba ye-plateau. I-condoral femyles yenza i-distal portion ye-femur, eyandiswa ukuze incedise ukusabalalisa isisindo emadolweni. I-condyle ye-femoral yinto ephezulu kwaye ijikeleze. I-condyles ibumbene kwangaphakathi ukuze inikezele ubuso bomhlaba we patella, kodwa bahlukana ngokugqithiseleyo nge-notch. Le notshi, okanye i-fossa, yindawo yesinamathiselo kwiimigqaliselo ezibalulekileyo, iigaments zikaHumphrey kunye neWrisberg, kunye ne-frenulum ye-patellar fat pad. Inxalenye enkulu ye-postal femalur ephezulu ibizwa ngokuba yi-popliteal surface. Lo mmandla uphelelwe ngamanqatha, owahlula kwi-arthritis. Amaphethelo aphakathi kunye nongxowankulu kwindawo yokuxhamla iindawo ezixhamliweyo zeemisipha. Ukugqwesa kwiimpawu zentombi ziyi-epicondyles, eziyizona ndawo ezixhamliweyo kwiimisipha, iintambo kunye nemigqa ye-capsular. I-epicondyle ye-medial isayithi yokuxhamla kwi-medial (okanye tibial) yegilateral ligament (Umfanekiso 83). I-epicondyle ye-femal latal iyisayithi yokunamathisela kwi-latal (okanye i-fibular) i-ligamental ligament, kunye ne-tendon ye-popliteus muscle, i-fibon ye-iriotibial tract, kunye ne-latal capsular ligament. Uphakamileyo kunye nomva ophezulu kwii-epicondyles yinkalo ephezulu kakhulu ye-linea aspera, i-ridge ye-bony ye-femur.

I-tibia yiyona nxalenye ye-distal ye-tibiofemoral ecacile emadolweni. I-tibia iyona ithambo lesibini elide kunabo bonke emzimbeni, libekwe emva kwe-femur. Isiphelo saso siphezulu kwaye sandisiwe ukuze sinikezele ummandla omkhulu kumzimba womzimba osasazwa nge-femur. Njengowesifazana, i-tibia ehamba phambili ine-condyles ye-medial. I-condyle ye-medie ikhudlwana, kwaye ithile ifuthe xa idibana ne-meniscus yangaphakathi. I-condyle ye-lateral ine-setyhula ijonge kwi-surface articular yayo. I-condyle ye-lateral i-condyle ichaza ngentloko ye-fibula emva koko, esondele ngokukhawuleza njengoko i-fibula ifika kuyo nayiphi na inxaxheba emadolweni. Kokubili ukuphakama kwamagama kunye nokuxhamla kwimiba ephakamileyo kwimiba ephezulu ye-tibia yokwenza iphakamileyo ye-intercondylar. I-posterior kule ndawo ephakamileyo yimihlaba eqhotyoshelweyo kwiimpondo eziphambili ze-menisci, eziza kuxutyushwa kunye nemigudu yegama. Iimpawu zendlela ephakathi kunye nezobuxhakaxhaka, kunye nommandla wobukhulu be-intercondylar zihlala ziqokelelane kwaye zibhekiswe njengengqithi ye-tibial (Umfanekiso we-84). Le ndawo ibaluleke kakhulu, kwaye ichaphazela kakhulu ukuzinza kwamadolo. I-tuberosity ye-tibial (okanye i-tubercle) ifumaneka kummandla wangaphakathi we-shabi we-tibial shaft. Inesabelo esiphezulu esiphezulu, kunye nesahlulo esezantsi esicatshulwayo, eso siza sokufakela kwi-tendon patellar. Icala elixhamlayo le-tuberosity le-tibial linomgca we-attachment yefayili ukusuka kwiphepha le-aliotibial. Le yiyona ndawo eqhotyoshelweyo ngokuthe ngqo kwiphepha le-aliotibial. Iphepha le-IT, okanye iqela, lisiza ekunciphiseni ukunyakaza kwethambo.

 

 

 

 

 

 

 

 

 

 

I-patella yithambo lesithathu elibandakanyekayo kwi-joint joint, ngokukodwa kwi-patellofemoral articulation. UPatella uthetha �ipleyiti encinci� ngesiLatini, echaza inkangeleko kunye nomsebenzi weli thambo lesamoid. I-patella ikhula kwi-tendon ye-quadriceps femoris muscle (Umfanekiso 85). Ihamba xa umlenze uhamba, kwaye ikhusela idolo elihlangeneyo ngokukhulula ukungqubuzana phakathi kwamathambo kunye nezihlunu xa idolo ligobile okanye liqondile. Ukudibanisa kwe-patellofemoral yi-saddle-type synovial joint, evumela ukuba i-patella ihambe ngaphaya kwendawo yangaphambili ye-femur phakathi kwee-condyles ze-femoral kwi-patellofemoral groove. I-Ossification ye-patella idla ngokugqitywa kwabasetyhini ngeminyaka eyi-10, kwaye kumadoda aphakathi kweminyaka eyi-13-16. Ukuba i-patella ineziko le-ossification elingaphezulu kwesinye, kwaye iziko elongezelelweyo alifaki i-fuse, libizwa ngokuba yi-bipartite patella (Umfanekiso 86).

 

 

 

 

 

 

 

 

 

 

 

I-Articular, okanye i-hyaline, i-cartilage igubungela iziphelo zamathambo abandakanyekayo kuyo nayiphi na idibeneyo. Kwi-joint joint, oku kubandakanya ukuphela kwe-distal ye-femur, i-proximal end of the tibia, kunye ne-posterior aspect of patella (Umfanekiso 87). Kumalungu amakhulu, le cartilage imalunga �� ngqindilili. I-Articular cartilage imhlophe, iyabengezela, irabha, kwaye imtyibilizi, nto leyo eyenza ukuba imiphezulu ikwazi ukutyibilika enye kwenye ngaphandle komonakalo. I-Articular cartilage iguquguquka kakhulu, ngenxa yenxalenye yamanzi aphakamileyo, okwenza ukuba ibonakale kakhulu kwi-MRI. Ngokwahlukileyo kumathambo ewagubungelayo, i-articular cartilage phantse ayinayo imithambo yegazi, ngoko ayilunganga ukuzilungisa. Amathambo wona anemithambo yegazi emininzi, kwaye akulungele ukuzilungisa.

Olunye uhlobo lwe-cartilage lufumaneka phakathi kwe-femur kunye ne-tibia- i-fibrous cartilage eyenza i-menisci ephakathi kunye ne-lateral. I-menisci, ekwabizwa ngokuba �articular disks�, ijikeleze iziphelo ezijikelezayo ze-femur ukugcwalisa indawo phakathi kwe-femur kunye ne-tibia (Umfanekiso 88). Ekubeni i-menisci ine-fibrous ekubunjweni kwayo, inamandla okuqina kwaye inokumelana noxinzelelo. Banokunceda ukusasaza amandla obunzima bomzimba wethu kwindawo enkulu. Ngokuncedisa ukusabalalisa ubunzima, i-menisci ikhusela i-articular cartilage ekupheleni kwamathambo ukusuka kumandla amaninzi. I-menisci yenziwe ukuba ibe ngqindilili ngaphandle kwayo, idala isokhethi enzulu kumphezulu we-tibial. Zisebenza njengengqayi kwindawo engqukuva ye-distal ye-femur, ziphucula uzinzo ngokubanzi lwejoyinti yedolo ngokuthintela nakuphi na “ukuqengqeleka” kwe-femur. Nangona isandi esinamandla, i-menisci inokukrazula okanye ikrazule xa idolo lijikeleza ngamandla okanye ligobile. I-meniscus ye-medial ixutywe kunye ne-medial collateral ligament, ngoko ke ayihambanga kancinci kune-lateral meniscus. Ihlala yenzakala xa i-anterior okanye i-posterior cruciate ligaments yenzakele. I-2/3 yangaphakathi ye-meniscus ye-medial ifumana unikezelo lwegazi olulinganiselwe, ngoko ke yonke i-meniscus idla ngokukhawuleza ukuphilisa. I-meniscus esecaleni inengxaki yokonzakala okumbalwa kune-meniscus yangaphakathi. Iinyembezi ze-Meniscal yenye yezona zinto ziqhelekileyo ezibangela iintlungu zedolo, kunye neenyembezi ezikrokrelwayo ze-meniscal esona sibonakaliso siqhelekileyo kwi-MRI yedolo elihlangeneyo.

Iimpawu ezinokuthi zibonise ingxaki ngamathambo eedolo ezihlangeneyo ziquka ukutshixa umdibaniso, idolo elinika indlela, ukukrazula okanye ukugaya kuvakalelwa ngokubambisana, kunye nentlungu kunye nokuvuvukala. Ukutshixa ilungu kunokubonisa �umzimba okhululekileyo� (ithambo, intlala, okanye into yangaphandle) kwindawo edibeneyo, enokususwa rhoqo nge-arthroscopy (Umfanekiso 89). Idolo elinikezelayo lingabonisa ukuba i-patella iphuma kwi-patellofemoral groove, eshiya idolo lingazinzile. Ukuqhaqha kunye nokugaya kwi-joint kunokukhokelela kwi-arthritis ephazamisayo okanye i-osteoarthritis, kunye ne-patella ekhuphayo. Ukwanda kweentlungu kunye nomsebenzi kunokwenzeka ngenxa yokuphulwa koxinzelelo okanye ukuphuka kwamathambo. Enye yeemeko ze-pathologic ezinokuthi zichaphazele amathambo amadolo ahlangeneyo yi-osteochondritis dissecans, enokuchaphazela i-distal femur, kwaye yaxutyushwa ngaphambili kunye ne-femur anatomy. Iindidi ezahlukeneyo ze-arthritis zibonakala kumathambo edolo elihlangeneyo, kuquka i-osteoarthritis, isifo samathambo, kunye ne-rheumatoid arthritis. I-Chondromalacia patella, eyaziwa ngokuba yi-patellofemoral syndrome okanye �idolo lomgijimi� isiphumo sokucaphuka kwendawo engaphantsi kwepatella (Umfanekiso 91). Ukuba i-patella ayilandeleli ngokuchanekileyo kwi-patellofemoral groove, i-cartilage ye-articular inokuxubha ngokudibeneyo emadolweni (Umfanekiso 90). I-cartilage iyancipha, kwaye iyacaphuka kwaye ibe buhlungu. Le meko ixhaphake kakhulu kulutsha, iimbaleki ezisempilweni, ingakumbi abasetyhini kunye neembaleki ezineenyawo ezisicaba. Unyango luhlala luphumla kunye nonyango lomzimba ukolula kunye nokomeleza i-quads kunye ne-hamstrings. Ukuba utyando iyadingeka, inokuba yenze i-lateral release�, njengoko ukulandelwa okungaqhelekanga kwepatella kunokubangela ukuqiniswa kwezicubu ezisecaleni zedolo. Inkqubo yokukhululwa kwecala inqumla izicubu eziqinileyo, ngoko ke i-patella inokubuyela kwindawo yayo eqhelekileyo kunye nokulandelela. Isifo se-Osgood-Schlatter sibandakanya i-tuberosity ye-tibial yangaphambili, kunye ne-tendon patellar efaka kuloo tuberosity (Amanani 92, 93). Le meko ichaphazela abantwana ngexesha lokukhula kwabo, kwaye ifumaneka ngakumbi kumakhwenkwe. Ngethuba lokukhula, ukuchithwa kwe-quad muscle kubeka uxinzelelo olongezelelweyo kwi-tendon ye-patellar kwindawo yayo yokunamathisela kwi-tuberosity ye-tibial. Oku kunokubangela ukuqhekeka kwe-subacute avulsion kunye nokuvuvukala kwethenda. Ukukhula kwamathambo okugqithisileyo kwenzeka kwi-tuberosity, kwaye iqhuma kwi-tuberosity inokubonwa kwaye ivakale. Eli qhuma linokucaphuka kwaye lidumbe, nto leyo ebangela iintlungu edolweni nasemilenzeni. Le meko idla ngokuba mandundu ngokubaleka, ukutsiba, kunye nokunyuka izinyuko. U-Osgood-Schlatter ukholisa ukusombulula ngokuphumla, umkhenkce, ukucinezeleka kunye nokuphakama, kunye nokukhula kwamathambo omntwana.

 

 

 

 

 

 

 

 

 

 

 

IiLigaments Of The Knee

Iigamente ziyiqela lezintlungu ezinamaqhina axhuma amathambo. Zithathwa njenge �viscoelastic�, okuthetha ukuba zingakhula kancinci kancinci phantsi koxinzelelo, kodwa zibuyele kwimo yazo yantlandlolo xa ukuxinana kususiwe. Nangona kunjalo, ukuba isetyenziswe ixesha elide, okanye idibene ethile, iigamentsi azikwazi ukugcina isimo sazo sokuqala, kwaye ekugqibeleni ziyakrazula okanye zifake. Le ngenye yezizathu zokuthi umdibaniselwano odibeneyo kufuneka uphinde ubekwe ngokukhawuleza. Ukuba iigaments zide, zishiya idibeneyo zibuthathaka kwaye zixhomekeke ekuhambeni kwexesha elizayo. Izenzo zokululaza ezilawulwayo ukwandisa iigamente, kwaye wenze amanyathelo angaphezulu, ayingxenye yemihla ngemihla yabadlali, abavocavoca, abadansa, njl njl. Iimpawu ezinobungozi zingakhokelela kwizihlanganisi ezingaqinisekanga, ukugqoka i-cartilage, kwaye ekugqibeleni i-osteoarthritis. Imigama emininzi yamadolo adibeneyo yizona zakhiwo ezibalulekileyo ekulawuleni ukuzinza kwamadolo. Uninzi lwezi ligamentshi luchazwe kwicandelo le-femin anatomy section, njengoko zineenkcukacha kwi-distal femur. Iimigama ezibaluleke kakhulu ziya kuhlaziywa apha ngokubanzi iinkcukacha, ngokubhekiselele kwimisebenzi yazo emadolweni. Imigqaliselo eyinhloko ye-intracapsular ligaments yizona eziphambili eziphambili kunye neziphambili (izibalo ze-94, i-95). Intracapsular ligaments aziqhelekanga kwizihlanganisi ze-synovial. Banikezela ukuzinza, kodwa vumela uluhlu olukhulu lokunyuka xa kuthelekiswa nemigqa ye-capsular okanye ye-extracapsular ligaments. I-ACL) ehamba phambili ivela kwi-condyle ye-femal yangasemva kwi-interior yangaphakathi ye-tibia, ekuthintela ukuba i-tibia isuswe kakhulu kwi-international relation to the femur. Kuye kwalimala kakhudlwana kwiimbonda eziphambili, kwaye ziyakrazulwa ngexesha lokuchopha nokuguqa kwamadolo. Abafazi basemngciphekweni ophezulu wokuphulwa kwe-ACL ngenxa yeengqinamba ukuba ububanzi obukhulu be-intercondylar fossa bubume bayo (emva kokuba i-ACL ifakeka kwangaphambili), kwaye ububanzi bonke be-intercondylar fossa bincinci kubasetyhini. I-posterior cruciate ligament (i-PCL) ehamba phambili isuka kwi-condyle ye-femoral kwi-posterior intercondylar endaweni ye-tibia, ekuthintela ukufuduka kwendawo yokuhamba kwe-tibia ehambelana ne-femur. Yomeleleyo yimizila emibini ebambelelekileyo, kwaye yalimala ngaphantsi; nangona kunjalo, inokulimala ukusuka kumandla okanye ukuxhatshazwa. I-menisci ikwajongwa njengezakhiwo ze-intracapsular, kunye nokudibanisa kwiigaments ngaphakathi nangaphandle kwe-capsule ehlangeneyo. Iimbambano zabo ezimbini ze-intracapsular ziyi-ligaments yangaphambili kunye neyokugqibela ehamba phambili. Bafakela i-menisci yomdibaniselwano kunye nomxhasi omnye komnye kwimimandla yabo yangaphambili nangemuva. Iimpazamo ezingezantsi ezingezantsi ezingenakudlula-kuphela i-1-4% yamadolo aya kuba nayo. Iimigamente ezimbini ezongezelelweyo ze-intermeniscal ligaments are ligaments medial and lateral meniscomeniscal ligaments (Umfanekiso 96). Amagama abo achaza iindawo zazo zokuncedisa uphondo lwangaphambili; banamathisela uphondo olungaphaya komnxeba (ie ie i-oblique meniscomeniscal ehlangene nophondo lwangaphambili lwe-meniscus eliphakathi kunye nophondo olungaphaya kwe-meniscus).

 

I-ligament (okanye i-tibial) i-ligamentary ligament ithathwa njenge-ligs capsula, njengoko inxalenye yechungechunge ye-articular ejikeleze i-synovial knee joint. Isebenza njengokwenziwa kombane ngokubambisana, ukukhusela idolo kwi-valgus force, okanye ukulungelelana ngokukhawuleza ngenxa yoxinzelelo kwicala elixhasayo lamadolo. I-collateral ligament (MCL) yenye yeyona nto ixhaphakileyo kakhulu kuyo yonke imigudu yegolo, eyenzeka kuyo yonke imidlalo, kuwo onke amaxesha, kunye namaxesha amaninzi kunye neenyembezi zamadoda (iifayile 98-101). Iqukethe izinto ezinzulu kunye nezobunzulu. Iifubers ukusuka kwingxenye engaphelelanga ye-MCL iqhotyoshelweyo kwi-epicondyle ye-femic kunye ne-condyle ye-medibial. Iifibers ezivela kwi-deep-colalateral ligament zixhomekeke kwi-meniscus ephakathi. Ukuxhomekeka kwinqanaba lokunamathisela, le ligament ibhekiselwa kuyo njengendoda yesigxina, njengoko idibanisa i-meniscus ephakathi kwimiba yomfazi. Ukungafani nokuqhotyosheliswa kwe-meniscal, i-ligament ibizwa ngokuba yi-meniscotibial (okanye i-coronary) ligament, njengoko idibanisa i-meniscus ephakathi kwimiba ephakathi. I-menisco-sorem kunye ne-meniscotibial zikwabizwa ngokuba yi-meniscocapsular okanye i-capsular ligaments, njengokuba zidlala indima ebalulekileyo ekumanyeleni izingxenyeni zomda we-meniscus ephakathi kwamadolo. I-meniscotibial ligament iyalimaza ngokuphindaphindiweyo kunegama le-meniscofemoral. I-meniscotibial ligament inamathele kwiimitha ezili-millimeters ezingaphantsi kwe-cartilage ye-articular. Umsebenzi wayo ukuzinzisa nokugcina i-meniscus kwindawo efanelekileyo kwi-plateau. Ukuphazanyiswa kwendoda ye-meniscotibial ligament kungakhokelela ekubeni i-meniscus ejikelezayo okanye ukuxoshwa kwamadoda, ngelixa i-ligam e-meniscofemoral ayinakuchaphazeleka. Ubunzulu obunzima bokubambisa i-ligament bufutshane, kwaye buqinisa ngokukhawuleza ngokujikeleza. Ngokuqhelekileyo yonakaliswe, kunye ne-ACL, xa indlela yokulimala ibandakanya ukujikeleza kwe-tibial. Ukuxilongwa kunye nokulungiswa kokucoca kwendawo yokugulana yinkxalaba enokuba yinto enzima kunokuba nzima.

 

Ukongeza kwimicu ye-collateral ligament ye-medial collateral ligament, inxalenye enzulu ye-capsular compartment yedolo eliphakathi yindawo yokuxhasa ngasemva kwedolo eliphakathi. I-posterior oblique ligament ifakwe ngokusondeleyo kwi-adductor tubercle ye-femur, kunye ne-distally kwi-tibia kunye ne-posterior aspect of the knee joint capsule. Ukuba i-oblique yangasemva yonzakele, idla ngokukrazulwa kwimvelaphi yayo yesifazane. I-posterior oblique ligament inikezela ukuchasana kwe-static kwimithwalo ye-valgus njengoko idolo liqhubela phambili kwisandiso esipheleleyo, kunye nokuzinza okuguquguqukayo kumandla e-valgus (uxinzelelo olusuka kwicala elisecaleni) njengoko idolo lihamba kwi-flexion. Isebenza njengesithintelo esibalulekileyo emva komthi ukuguqulelwa kwiimeko zokulimala kwe-posterior cruciate ligament. I-oblique ligament yangasemva ineengalo ezintathu. Ingalo yayo ephezulu ye-capsular iba ngokuqhubekayo kunye ne-capsule yamadolo angasemva, kunye nenxalenye esondeleyo ye-oblique popliteal ligament. I-oblique popliteal ligament nayo iyisakhiwo esibalulekileyo sokuzinzisa ngasemva kwi-knee joint Figure 102). Isuka kwinqanaba le-posteromedial ye-tibia, iqhube i-oblique kunye ne-lateral ukuya phezulu ukuze ifake kufuphi ne-epicondyle ye-lateral ye-femur.

 

I-lateral (okanye i-fibular) i-collateral ligament ithathwa njenge-extracapsular ligament. Inceda ukubonelela ngokuzinza ngokubambisana kunye nokukhusela icala elisecaleni lamadolo ukusuka kumandla e-varus, okanye ngaphakathi kwemikhosi yokugoba ejoliswe kwicala eliphakathi kwedolo. Ukulimala kwi-lateral collateral ligament ayiqhelekanga kunokulimala kwi-collateral collateral, njengoko umlenze ochaseneyo unokugada imikhosi ye-medial engakhokelela ekulimazeni kwe-lateral collateral. Ukulimala kunokwenzeka kwimidlalo efana nebhola ekhatywayo kunye nombhoxo, apho idolo landiswa kwaye lingakhuselekanga ngexesha lokugijima. I-lateral, okanye i-fibular, i-collateral ligament ilula i-oblique ezantsi nasemva, ukusuka kwi-epicondyle esecaleni ye-femur ukuya kwintloko ye-fibula (Umfanekiso 103). Ayixutywanga ne-capsular ligament okanye nge-lateral meniscus, ngoko iye yanda ukuguquguquka kunye nokunciphisa iziganeko zokulimala xa kuthelekiswa ne-medial collateral ligament. Ngokufana ne-meniscus yangaphakathi, i-meniscus esecaleni ine-meniscotibial, okanye i-coronary, ligament. Idibanisa imida engaphantsi ye-meniscus esecaleni ukuya kwi-periphery ye-tibial plateau. I-meniscus yecala nayo ine-meniscofemoral ligament ephuma kwiphondo elingasemva le-meniscus yecala ukuya kwinqanaba elisecaleni le-condyle ye-femoral medial. Inikwa amagama amabini ahlukeneyo, ngokusekelwe kwindawo yayo ngokumalunga ne-posterior cruciate ligament (PCL). I-ligament ye-Humphrey idlula phambi kwe-posterior cruciate ligament. Ingaphantsi kwe-1/3 ububanzi be-posterior cruciate ligament, kodwa inokudideka kwi-posterior cruciate ngexesha le-arthroscopy. ILigament yaseWrisberg idlula ngasemva kweligament ye-posterior cruciate, kwaye imalunga � nediameter ye-posterior cruciate (Figure 104). Imvelaphi yayo yobufazi ihlala idibanisa kunye ne-posterior cruciate ligament. Zombini iigaments zikhona kuphela malunga ne-6% yamadolo. Phantse i-70% yabantu inomnye okanye enye yale ligaments, kunye nesininzi esiphethe i-posterior ligament ye-Wrisberg (Umfanekiso we-105). I-MRI yindlela yokucinga ekhethiweyo yokulimala kwe-collateral okanye i-lateral collateral ligament, njengoko inokubona nayiphi na i-derangements yangaphakathi yamadolo edibeneyo, ukulimala kwe-cruciate-collateral ligament, okanye ukusilela kwe-cartilage.

I-patellar ligament yintsebenziswano phakathi kwe-patella kunye ne-tibia, ephuma kwi-apex (inkalo ephantsi) ye-patella kwi-tuberosity ye-tibial. Ngokobuchwephesha, idibanisa amathambo amabini, ngoko ke ligament. Nangona kunjalo, idla ngokubizwa ngokuba yi-patellar tendon, kuba iifayili ezingaphezulu ezigubungela i-patella kunye nokwandisa kwi-tibia ziyaqhubeka kunye nenxalenye ephakathi ye-tendon eqhelekileyo ye-quadriceps femoris muscle. I-posterior surface ye-patellar ligament ihlukaniswe kwi-membrane ye-synovial ye-knee edibeneyo yi-pad infrapatellar pad enkulu. Ukulimala kwi-patellar ligament kungenzeka ngenxa yokusetyenziswa ngokugqithiseleyo, njengemidlalo ebandakanya ukuxhuma kunye nokutshintsha ngokukhawuleza kwesikhokelo, kunye nemidlalo ehambelana nokugijima. Le ligament elenzakele kwi-jumper's knee (okanye i-patellar tendonitis), eqala ngokuvuvukala, kwaye ingakhokelela ekunciphiseni okanye ukuphuka kwe-patellar ligament kunye nezicubu ezijikelezayo (Umfanekiso 106). Izigulane ezinokulimala kwe-patellar ligament ngokuqhelekileyo zikhalaza ngentlungu kwindawo engaphantsi kwe-kneecap, eya kwanda ngokuhamba, ukugijima, ukukhwela, njl njl. ukuphakama. I-patellar ligament attachment kwi-tuberosity ye-tibial yindawo ye-Osgood-Schlatter isifo, esaxoxwa ngayo ngaphambili.

Emacaleni e-patella kunye ne-patellar ligament yi-medial kunye ne-lateral patellar retinacula (Umfanekiso we-107). Ziyi-fibrous tissue stabilizers kwi-patella eyenza ukusuka kwi-medial kunye ne-lateral ye-tendon ye-quad njengoko idlula phantsi ukuze ifake ngapha nangapha kwe-tuberosity ye-tibial. I-retinaculum esecaleni ingqindilili kwezi zimbini, kodwa zombini zinemigangatho engaphezulu kunye nenzulu. Ngaphakathi kweengqimba ezinzulu kukho imigqa eyahlukeneyo (amagama abo abonisa izakhiwo ezidibanisayo) ezinceda ukuxhasa i-patella kwindawo yayo, ngokumalunga ne-femur engaphantsi kwayo. Uluhlu olunzulu lwe-lateral patellar retinaculum yindawo apho i-lateral patellofemoral ligament idibana nebhendi ye-iliopatellar, eyingqungquthela yeentambo ezivela kwi-iliotibial (IT) band edibanisa ne-patella. Uluhlu olunzulu lwe-patellar retinaculum ye-medial ine-focal capsular thickenings, ebizwa ngokuba yi-patellofemoral ye-medial, i-patellomeniscal ephakathi, kunye ne-medial patellotibial ligaments. I-patellofemoral ligament ye-medial yomelele ngokwaneleyo ukuba ithintele ukulandelela i-patellar, kwaye yenza njengento enkulu yokuthintela. Ukungalingani kwimikhosi elawula ukulandelwa kwe-patellar ngexesha lokuguqa kunye nokwandiswa kwamadolo kunokukhokelela kwi-patellofemoral pain syndrome (idolo lomgijimi), enye yezona zinto zibangela iintlungu zedolo. Oku kunokubangelwa ukusetyenziswa ngokugqithiseleyo, ukwenzakala, ukungasebenzi kakuhle kwezihlunu, i-patellar hypermobility, kunye nokungaguquguquki kwe-quadriceps. Iimpawu eziqhelekileyo ziquka intlungu emva okanye ejikeleze i-patella eyonyuswa ngokubaleka, kunye nemisebenzi ebandakanya ukuguqa kwedolo. I-MRI ngokuqhelekileyo ayiyimfuneko kolu kuxilongwa. Unyango lomzimba lufunyenwe lusebenza kakuhle kunyango lwe-patellofemoral pain syndrome.

Imisipha kunye neethenda zedolo

I-flexor ne-extensor muscle zamadolo ziye zaxutyushwa ngaphambili, njengoko uninzi lwazo zingama-muscle anterior and posterior of the thigh. Siza kuhlolisisa imisipha yamathanga echaphazelekayo ekuhambeni kwamadolo, kwaye ungeze izihlunu ezimbini zomlenze ophantsi ochaphazela emadolweni. Iimpawu ze-femadis ze-femoris zomlenze wangaphambili ziyi-knee-extensors eziphambili (Umfanekiso 108). Njengoko le mvumelwano yomsila, idolo lihlangene. I-tendus ye-vastus medialis, i-vastus intermedius, i-vastus lateralis, kunye ne-rectus femoris zidibanisa kumgangatho ophezulu (isiseko) se patella ukuba yenze i-tendon patellar. Le toni iyaqhubeka phezu kwe patella kwaye iyifaka kwi-tuberosity ye-tibial (ekubeni idibanisa ithambo kwisithambo, ngamanye amaxesha libizwa ngokuba yi-ligellar ligament). I-quadriceps, kunye nezihlunu ezinobungqingili, zixanduva lwemigudu efuna ukuhamba, ukugijima, nokuxumla. Iinqununu nazo zinceda ukulawula ukunyakaza kwe patella, njengoko ziqhotyoshelwe kuyo ngeetonons ze-quadriceps (Umfanekiso 109). I-patella ikwandisa amandla asebenzayo ngamasipha e-quadriceps njengoko idolo liqondiswa.

 

 

 

 

 

 

 

 

 

 

 

 

 

Imisipha ye-enderior, eyaziwa nangokuthi i-hamstrings, i-knee-flexers, i-sartorius, i-gracilis, i-gastrocnemius kunye ne-popliteus muscle. Amadolo aguqa xa ikhonkco yenzalo. Imisipha yokugudla iguqa idolo idibanisa amandla afunekayo ekuqhubekeni nasekusebenzeni. Ziyakunceda ukuzinzisa idolo ngokukhusela iimbumba kunye neziphambano eziphambili, ngakumbi xa igubu ligugu. Ezi zihlunu zintathu zintsimbi ziye zahluka kwiindawo ezixhamliweyo ezihlangene nomgca weedolo (Umfanekiso 110). I-biceps i-femoris ifakela entloko ye-fibula kunye nomxholo ophezulu we-tibia. I-semitendinosus ifakela kumbandela wangaphakathi we-tibia, ephakathi kwe-tuberosity tibial, ewela ngaphaya kwe-collateral ligament. Ngamanye amaxesha isithoni se-semitendinosus muscle sisetyenziselwa ukuhlaziywa kwegilite. I-semimembranosus ifakwa kwi-posteriomedial aspect of the tiyleal condyle. I-sartorius muscle nayo iguqule i-knee flexor, nangona yinto engumlenze wangaphambili wethanga. Ifaka umbandela wezokwelapha zangaphambili we-tibia. Umsila we-gracilis womlenze womlambo ungomnye wabakhweli be-hip, kodwa uphinde udlale inxaxheba emadolweni. Njengoko i-semitendinosus tendon, i-tendon ye-gracilis ngamanye amaxesha isetyenziselwa ukulungiswa kwe-ligament reconstructions. I-gracilis ifakela kumbandela ohambelana nawo.

I-flexors eyongezelelweyo yexolo elihlangeneyo liquka ezinye zezihlunu zangasemva zomlenze ongezantsi. I-muscle enkulu ye-gastrocnemius ine-head and medial head, ephuma kwimimiselo yecala kunye neyengxowankulu, ngokulandelanayo. Ibaleka ubude bomlenze ophantsi ongaphantsi, udibanisa kwi-calcaneus nge-tendon ye-Achilles. I-gastrocnemius isinika amandla okuchukumisa idolo lethu ngelixa unyawo lwethu lugxininiswa, njengoko ludibanisa kumabini omabini. Kubandakanya ukuma, ukuhamba, ukugijima, nokuxumla. I-popliteus yindawo enzulu engaphantsi kwemilenze ephantsi emlenzeni owanceda ngokuguqa ngamadolo, kwaye ibuye ijikeleze i-tibia phakathi, eyanceda ekuzinzileni kwamadolo. I-poplite ivela kwimida yangaphandle ye-meniscus yangaphambili yexolo. Iyakwandisa emva kwendawo kwaye iphinde ifake umbandela we-tibia, ngaphantsi kwe-epicondyle ye-tibial.

Iintambo ezibalulekileyo zamadolo ziquka i-quadriceps, i-patellar, kunye ne-hamstring tendon, kunye nebhendi ye-iliotibial (Umfanekiso 111). Iitendon zincamathelisa izihlunu emathanjeni. Ezi zithonjana ezinkulu zamadolo ziye zaxoxwa kunye nokuba ngamathambo okanye izihlunu ezizincamatheleyo. Ithenda ye-quadriceps yakhankanywa kunye nesihlunu se-quadriceps njengesihlunu esincamathela kwi-patella. I-tendon ye-quad iyaqhubeka phezu kwe-patella, emva koko ifake i-apex ye-patella kwi-tuberosity ye-tibial. Emva koko ibizwa ngokuba yi-patellar tendon (okanye i-ligament). I-Hamstring tendons yaxutyushwa kunye nemisipha ye-hamstring, imisipha yangasemva eguquguqukayo emadolweni. Ngamanye amaxesha ii-tendon ze-Hamstring zisetyenziselwa ukulungiswa kwakhona kwe-cruciate ligament. I-Tendonitis, oku kukuvuvukala kwe-tendon, yinto eqhelekileyo yokulimala kwamadolo phakathi kwabadlali kwimidlalo eyahlukeneyo. Ibhendi ye-iliotibial (okanye i-IT tract) isebenza njenge-tendon, njengoko idibanisa idolo kwi-tensor fasciae latte muscle. Ibhendi ngokwenene i-fibrous reinforcement ye-fascia lata, okanye izicubu ezinzulu zethanga. Ihamba ukusuka kwi-ilium ukuya kwi-tibia. Ngokusondeleyo, isebenza njenge-hip abductor, ngelixa i-distally isebenza njenge-lateral stabilization for the knee, kunye nokuncedisa ngokujikeleza okuphakathi kwe-tibia. Ibhendi ye-IT isetyenziswa rhoqo ngexesha lokuhamba kunye nokusebenza, oku kunokukhokelela ekucaphukeni kwindawo apho idlula khona i-epicondyle ye-femoral lateral. Ibhendi ye-IT inokubangela ukuvuvukala kunye / okanye ukucaphuka kwi-epicondyle ye-femal, okanye kwindawo yokufakwa kwi-condyle ye-lateral tibial. Le meko ibizwa ngokuba yi-IT band friction syndrome. Iqhelekile phakathi kweembaleki, abakhweli, kunye nabathandi beebhayisekile.

Amagalelo E-Knee

Iimbilini eziphambili emadolweni ezivela kwi-sacral plexus ye-nerve yi-nerve ye-tibial kunye ne-peroneal nerve eqhelekileyo (Umfanekiso 112). Omabini ngamasebe e-nerve ye-sciatic, kwaye aqala ngasemva, kancinci ngaphezu kwedolo elihlangeneyo. Zombini ezi mithambo-luvo, okanye amasebe azo, ziqhubeka ngomlenze ongezantsi kunye nonyawo, zibonelela ngemvakalelo kunye nokulawulwa kwemisipha. I-tibial kunye ne-common peroneal nerves nazo zombini zibandakanyeka kwi-cutaneous innervation, ekunikezelwa kweentsholongwane elukhumbeni lwamadolo. I-nerve ye-tibial ihlala ingasemva kunye ne-medial ngakumbi, i-branching kwi-ankle ephakathi ukuze ingabikho unyawo. I-nerve ye-peroneal eqhelekileyo iqala i-posterolaterally, ihamba phambili kufuphi nentamo ye-fibula. Emva koko ihlahlela kwimithambo-luvo engaphezulu kunye nenzulu ye-peroneal, eqhubeka nokuhla kwabo kwangaphambili ukuya ezinyaweni. I-tibial kunye ne-peroneal nerves eziqhelekileyo zezona zixhaphakileyo zokulimala xa idolo lichithwa. Imithambo-luvo inokuphinda ikhule, kodwa ikwenza oko ngesantya esimalunga nee-intshi � ngenyanga.

Amagxa avela kwi-lumbar plexus echaphazela emadolweni afaka i-lateral femoral cutaneous, kunye ne-saphenous, eyisebe le-nervous nerve (Umfanekiso 113). I-nethinous nererve ihamba ngokubanzi kwaye inika amasebe e-infrapatellar macala. Ngaphantsi kweedolo, i-nerve saphenous ithumela amagatsha elukhunjini lomlenze ongezantsi naphakathi. I-nerveal cutaneous nerve ye-femour ithumela i-anterior yesebe kwesikhumba se-anterior and lateral thigh, ukuya endaweni yodolo. I-Terminal filaments yale ntsho ithetha ne-infrapatellar yesebe yesinstenous, eyenza iplexus ye-peripatellar.

Imithambo kunye nemithambo yedolo

Umthambo we-popliteal, isebe lomzobo wesifazane ongowona mnye, ngowona nto iguqulwa ngamadolo. Ibaleka ngaphaya kombono ongasemva we-distal femur, emva kwexolo elihlangeneyo. Kwi-ridge ye-supracondylar, umthambo we-popliteal unikezela igazi kwi-knee, equlethwe yimithambo ye-genicular (Figure 114). Ngaphantsi kwamadolo, ama-popliteal amagatsha angena emiphandleni yangaphambili nangemva kwe-tibial, enika umlenze ongezantsi. Umthambo we-popliteal iyindawo eqhelekileyo ye-atherosclerosis kunye ne-aneurysms, kwaye idibene njengeyona ndawo eqhelekileyo kwimimandla ye-aneurysms ye-peripheral. Ngokumalunga ne-50% yalezi zine-aneurysms ziphakathi. Nangona ziqhekeza ngokungaqhelekanga, ii-aneurysms ezinama-poplite zinokuthi zijolise ekugqibeleni ngokunyanzeliswa kwe-thrombotic ukubandakanywa kwe-popliteal artery, enokuchaphazela unyawo kwicala elinye. I-thrombus ngaphakathi kwe-aneurysm ingakhokelela ekugqibeleni. Iimpawu ze-genicular ziyimithombo yokuqhubela kwegazi ngokuqhubekayo ukuya emadolweni nasemlenzeni ongezantsi, xa kwenzeka umthi we-popliteal ophazamisekileyo. Ukuhla kwe-genicular, ebizwa ngokuba yiyona ephezulu okanye eyona nto iphezulu, iifesi ezisuka kwintsimbi yesifazane, iphakamileyo kunegatsha le-popliteal. Unika i-adductor magnus kunye neengxube zengqungquthela, kwaye idibanisa kunye nenethiwekhi yeetriyetyriyriyiti ezijikelezayo. I-genicular ephakathi ihlaba i-liglic oblique popliteal ligament, kwaye inika iigaments kunye ne-synovial membrane ngaphakathi kwegama lokuguqa (kuquka i-ACL ne-PCL). Umzobo we-sural ujoyina i-anastomoses ye-articular arteries, kunye nokubonelela izihlunu zomlenze ongezantsi, kuquka i-gastrocnemius muscle enkulu. Iprogram ye-anastomotic ejikeleze idolo elixhasayo linikezelwa ngumzobo we-popliteal emva kwexesha, ukuhla kweempawu zobuncwane, kunye nokuhla kwecandelo le-lateral circumflex umzobo wesifazane. Iimpawu ze-genicular ezibandakanyeka kwi-anastomosis zibhalwa njenge-geniculars eziphambili kunye nezixhasayo, kunye ne-genicular inferior.

Iimvumba ezinzulu ezijikelezayo ezihlangene neendolo ziyi-popliteal vein, kunye nemithanjeni yangaphambili nangemva kwe-tibial (Umfanekiso we-115). Umlanjana we-popliteal uqala ekuhlanganiseni kweemithanjeni ezincinci kwisithuba esingaphantsi komlenze ongezantsi, ungaphantsi kwamadolo. Iyakhuphuka emva koko, iqhubeka njenge-vein vein malunga ne-halfway up to the thigh. Njengoko imithanjeni ejulile ilandele imiraro, iimfucu ze-genicular zihamba kunye nemithambo ye-genicular ehlangene nomdolo, kunye ne-vagin. Iimvumba ezibalulekileyo ezingxenyeni zamadolo zizona zincinci ezincinci. Iimvumba eziqhelekanga azilandelanga imirhoxo, kodwa kunoko ukuhamba ngeentsimbi zomzimba. Amancinci amancinci anyukela emlenzeni ongezantsi, ngokukhenkcela kwi-latal ukuya kwi-medial. Idibanisa ne-vepliteal vein kwisikhundla esiphezulu kunamavili. I-veen enkulu ye-saphenous, umlenze omde kakhulu emzimbeni, inomdla ophakathi kunye nomgangatho wangaphakathi emlenzeni ongezantsi. Ishukumela kwindawo ephezulu, kodwa ihlala emxineni kunye nodolo, ihamba kunye ne-epicondyle ye-femicur. I-saphenous enkulu ibuye ibuye ibuyele ngaphaya komlenze.

I-Varicose kunye �spider� imithambo idla ngokubonwa emlenzeni kwicala elingasemva ledolo. Njengoko kukhankanyiwe ngaphambili, kwingxoxo ye-femoral vein, imithambo ineevalvu zokuqinisekisa indlela enye-yokunyuka kwegazi elibuyela entliziyweni (Figure 116). Iinqanawa zokunxibelelana, ezikwabizwa ngokuba yi-perforating veins, zikhona phakathi kwemithambo enzulu kunye nephezulu ukunceda ukubuyisela iivalvu ezinokuthi zingasebenzi, kwaye zivumela ukuphindaphinda kwegazi. Ukuba iindonga ze-venous zibuthathaka okanye zihlanjululwe, i-cusps ye-valve ayikwazi ukuvaleka ngokufanelekileyo, kwaye iivalve ziyakwazi ukungakwazi. Oku kukhokelela ekwenyukeni kobunzima bomhlathi wegazi kwimithambo �ephantsi komsinga� ukusuka kwivalve embi. Igazi linokudityaniswa kule mithambo, ibangele ukuba ibe yi-varicose, apho imithambo idumba, ibe tortuous, kwaye ide idubule kumphezulu wolusu. Imithambo ye-reticular, eyimithambo emincinci ye-varicose engagqabhukiyo eluswini, kunye nemithambo emincinci yesigcawu zombini ziziimeko ezingenzima kangako, kodwa zombini zisabandakanya ukuphuma kwegazi ngasemva. Ukususwa kwemithambo ye-varicose enzima ngokwenene kuya kunceda ukuhamba kwegazi, njengoko igazi alisayi kuphinda lihlale kwiindawo ezidibeneyo.

Bursae Of The Knee

I-synovial knee joint likhaya kwinani elikhulu le-bursae (Umfanekiso 117). Ezi ziingxowa ze-fluid kunye ne-synovial pockets ezijikelezayo kwaye ngamanye amaxesha zinxibelelana ne-joint cavity. Baququzelela ukunyakaza okungahambiyo phakathi kwamathambo kunye nezakhiwo ezihambayo (i-tendon, imisipha). I-Fluid okanye i-debris inokuqokelela kwi-bursa, okanye i-fluid inokudlulela kwi-bursa ukusuka kwi-joint esondeleyo kwiimeko ezifana nokugqithisa okugqithisileyo, ukusuleleka okanye ukwenzakala ngokuthe ngqo. Olu hlobo lokwandiswa kwe-pathological ye-bursa kubhekiselwa kuyo njenge-bursitis, ekwazi ukulinganisa i-peripheral joint kunye ne-muscle engaqhelekanga. Iingcali zeradiology kufuneka zikwazi ukuchonga ngokuchanekileyo i-bursal pathology, ngakumbi phakathi kwe-knee bursae (i-14 echazwe kwezinye iincwadi). Siza kuchonga ezimbalwa ze-bursa eziqhelekileyo, ngokuqala nge-suprapatellar bursa. Le bursa ilele phakathi kwe-tendon ye-quadriceps kunye ne-femur, iphakamileyo kwi-patella (Umfanekiso 118). Ulwelo luqhele ukufunyanwa apha xa izigulane zidibene. I-Bursitis ye-prepatellar bursa ikwabizwa ngokuba 'yidolo lomfazi wasendlini'. Kwenzeka ngenxa yokwenzakala okuphinda-phindayo ukusuka ekuguqeni, njengoko kubonwa ngabancedi basekhaya, abajijisi, kunye nekhaphethi-izaleko. Le bursa ifumaneka phakathi kwepatella kunye nesikhumba (Umfanekiso 119). Ukudumba kwe-infrapatellar bursa engaphezulu kunokubizwa ngokuba �Idolo lomfundisi�, enye ibursitis enokuthi yenzeke ngenxa yokuguqa ngokugqithisileyo. Le bursa ifumaneka phakathi kwesithathu se-distal ye-tendon ye-patellar kunye nolusu olugqithisiweyo (Umfanekiso 120).

 

I-synovial sac yedolo edibeneyo ngamanye amaxesha yenza i-bulge yangasemva, eyaziwa ngokuba yi-Baker's cyst okanye i-popliteal cyst (Umfanekiso 121). Ngokuqhelekileyo ifom phakathi kwee-tendon zentloko ye-medial ye-gastrocnemius muscle kunye ne-semimembranosus muscle, ngasemva kwi-condyle ye-femoral medial. I-Baker's cysts ayizizo iicysts eziyinyani, njengoko zigcina unxibelelwano oluvulekileyo kunye ne-synovial sac. Nangona kunjalo, ziyakwazi ukucwina, kwaye zinokugqabhuka. Ngokuqhelekileyo azibonakalisi, kodwa zingabonakalisa enye ingxaki yamadolo, njenge-arthritis okanye i-meniscal tear. Ukuphefumla kwe-synovial fluid kunokwenziwa ukuba icyst iba yingxaki. Unyango ludla ngokuba yimfuneko ukuba i-cyst ye-Baker igqabhukile, njengoko inokubangela iintlungu ezibukhali emva kwedolo, kunye nokudumba kwezihlunu zethole. I-cyst eqhekekileyo inokulinganisa i-DVT okanye i-thrombophlebitis. I-Ultrasound kunye ne-MRI zinokusetyenziselwa zombini ukuqinisekiswa kwe-cyst ye-Baker (Umfanekiso 122).

Sula i Setups

Ezi zilandelayo ziphakamiso ze-HMSA zeengcamango zamadolo. Iiprotokholi ze-Knee kufuneka zenzelwe ukuvelisa imifanekiso yokuxilonga yamadoda, amathambo, i-articular cartilage kunye nazo zonke izakhiwo ezigulane zamadolo. Nangona ii-radiologists ezininzi zingadinga ukucinga okungeziweyo kwe-ACL, iiprotokthi eziye zenzelwe ukucinga ngendlela efanelekileyo ye-cartilage kunye ne-menisci kufuneka zivelise imifanekiso efanelekileyo ye-ACL. Njalo qwalasela i-radiologist yakho ngokukhetha kwakhe ukucinga.

Axial Scans

Xa ukubeka i-axial slices for knees, sagittal and coronal images ingasetyenziselwa ukuqinisekisa ukufakwa kwazo zonke i-anatomy ezifanelekileyo. Iingcezu zimele zandise ngokugqithiseleyo ukuba zibandakanye lonke i-patella, kwaye zingaphantsi kokubandakanya ukubola kwe-tibial kunye ne-patellar tapeon insertion. I-presat ingafakwa phezu komgca ongaphantsi ongenakuchaphazeleka ukunciphisa amathuba okumbumbisa i-artifact, njengoko kuboniswe kumfanekiso we-coronal kwi-Figure 139.

Sconal Scans

Iinqununu ze-Coronal zedolo zimele zibandakanye i-anatomy ukusuka kwimizila engaphantsi kwesimo sezesetyhini ukuya kwingxenye yangaphakathi ye patella. Jonga umgca umgca odibanisa i-condlates and medial condyles ye-femur. Ngokuqhelekileyo, iiconal slices are angled ukuze zilandelane naloo mgca, njengoko kuboniswe kumfanekiso we-axial kwi-Figure 140.

Sagittal Scans

Izilayi ze-Sagittal kufuneka zibandakanye i-anatomy ukusuka kwi-condyle ephakathi ukuya kwi-condyle esecaleni. Iqela lesilayi linokujongwa ngokokuthanda kwakho i-radiologist, kodwa kufuneka lihlale li-perpendicular kwizilayi ze-coronal. Ngokuqhelekileyo, iqela lesilayi lifakwe i-angle ukuze lihambelane nomda we-medial we-condyle ye-femoral, njengoko kubonwa kumfanekiso we-axial kuMfanekiso we-141.

Ukongeza kwimifanekiso ye-oblique ye-sagittal yesiqhelo, ezinye iingcali ze-radiologists zikhetha i-sagittal scan eyongezelelweyo ye-ACL enezilayi ezincinci kunye nesisombululo esiphezulu sendawo. Imifanekiso ye-axial kunye ne-coronal ingasetyenziselwa ukuseta isilayi. Uncwadi olubhekiselweyo lucebisa ukuba i-angle yeqela le-slice akufanele idlule i-10� ukusuka kumgca owenziwe nge-perpendicular kumgca we-bicondylar (umgca odibanisa i-condyles ye-femoral yangasemva), njengoko kubonwe kuMfanekiso we-142.