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Ultrasound imaging in professional soccer: when is it adequate? 职业足球运动中的超声波成像:何时足够?
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-04-01 Epub Date: 2023-12-28 DOI: 10.1007/s00256-023-04551-w
O 'Neill C P, Gerety E L, Grainger A J

Ultrasound imaging plays an important role in the diagnosis, monitoring and treatment of injuries in professional soccer players. With the rapid increase in the availability of hand-held portable ultrasound devices and the pressure to make timely and accurate diagnosis in professional soccer where return to play time is crucial, ultrasound imaging is an essential diagnostic tool. In this article, we discuss examples of injuries that can be adequately assessed by ultrasound imaging alone and injuries where ultrasound imaging provides a useful first step to guide further investigation and management.

超声波成像在诊断、监测和治疗职业足球运动员的损伤方面发挥着重要作用。随着手持便携式超声波设备的迅速普及,以及在职业足球比赛中及时准确地做出诊断的压力,超声波成像是一种必不可少的诊断工具。在本文中,我们将举例说明仅通过超声波成像就能充分评估的损伤,以及超声波成像可作为第一步指导进一步检查和治疗的损伤。
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引用次数: 0
Imaging of soccer injuries in adolescent female athletes. 青少年女运动员的足球损伤成像。
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-04-01 Epub Date: 2024-03-13 DOI: 10.1007/s00256-024-04629-z
Fernanda Babler, Kara Gaetke-Udager, Eileen A Crawford, Corrie M Yablon

Soccer participation is increasing among female adolescents with a concomitant rise of injuries in this group. Age- and sex-related factors, such as the transition from skeletal immaturity to skeletal maturity as well as anatomic, physiologic, neuromuscular, and behavioral differences between females and males, all play a role in injury patterns for these athletes. Anterior cruciate ligament (ACL) tears in this group have received a great deal of attention in the medical literature and the media in recent years with increasing knowledge about causative factors, surgical management, and injury prevention. There have been fewer studies specifically focused on female adolescent soccer players in relation to other types of injuries, such as patellar dislocation/instability; other knee and ankle ligament tears; hip labral tears; muscle strains and tears; and overuse injuries such as apophysitis, patellofemoral pain syndrome, and bone stress injuries. Because imaging plays a critical role in diagnosis of soccer-related injuries in female adolescents, knowledge of the mechanisms of injury, imaging findings, and clinical considerations are essential for radiologists involved in the care of these patients.

青少年女性参与足球运动的人数越来越多,与此同时,这一群体的受伤人数也在增加。与年龄和性别相关的因素,如从骨骼不成熟到骨骼成熟的转变,以及女性和男性在解剖、生理、神经肌肉和行为方面的差异,都对这些运动员的受伤模式产生了影响。近年来,随着对致伤因素、手术治疗和损伤预防知识的不断了解,医学文献和媒体对这类运动员的前十字韧带(ACL)撕裂问题给予了极大关注。专门针对青少年女足运动员与其他类型损伤(如髌骨脱位/不稳定、其他膝关节和踝关节韧带撕裂、髋关节唇裂、肌肉拉伤和撕裂以及过度运动损伤(如骨骺炎、髌股关节疼痛综合征和骨应力损伤))相关的研究较少。由于影像学在青少年女性足球相关损伤的诊断中起着至关重要的作用,因此了解损伤机制、影像学检查结果和临床注意事项对放射科医生治疗这些患者至关重要。
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引用次数: 0
Patterns of ankle injury in soccer: MRI clues to traumatic mechanism. 足球运动中的踝关节损伤模式:磁共振成像为创伤机制提供线索。
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-04-01 Epub Date: 2023-12-29 DOI: 10.1007/s00256-023-04547-6
Tetyana Gorbachova, Sherif S Saad, Ricard Pruna, Yulia V Melenevsky

Understanding the traumatic mechanisms of ankle injuries in soccer is crucial for an accurate and complete MRI diagnosis. Many ankle injuries share universal mechanisms seen in other athletic activities, but certain patterns are found to be more specific and relatively unique to soccer. Ankle impingement syndromes encountered in soccer encompass a spectrum of disorders that include anterior and posterior impingement categories, with anterior impingement representing pathology relatively specific to soccer. Lateral ligamentous sprains are one of the most common injuries; however, there is a higher rate of injuries to the medial structures in soccer as compared to other sports. Ankle fractures are uncommon in soccer while bone contusions and chondral and osteochondral injuries frequently accompany ligamentous sprains. Tendon abnormalities in soccer most commonly result from overuse injuries and typically affect peroneal tendons, posterior and anterior tibialis tendons, and Achilles tendon. Acute Achilles tendon ruptures occur in both recreational players and elite soccer athletes. Tibialis anterior friction syndrome may mimic tibial stress fractures. Long-term sequelae of acute traumatic and chronic overuse ankle injuries in professional soccer players manifest as ankle osteoarthritis that is more prevalent compared to not only the general population, but also to former elite athletes from other sports. This article examines the most common and specific injuries in soccer in order of their frequency.

了解足球运动中踝关节损伤的创伤机制对于准确、完整地进行核磁共振成像诊断至关重要。许多踝关节损伤都有其他运动中常见的普遍机制,但某些模式在足球运动中更为特殊和相对独特。足球运动中出现的踝关节撞击综合征包含一系列疾病,包括前撞击和后撞击两类,其中前撞击是足球运动中相对特殊的病理现象。外侧韧带扭伤是最常见的损伤之一;不过,与其他运动相比,足球运动中内侧结构的损伤率更高。踝关节骨折在足球运动中并不常见,而骨挫伤、软骨和骨软骨损伤则经常伴随着韧带扭伤。足球运动中的肌腱异常最常见于过度运动损伤,通常会影响腓骨肌腱、胫骨后肌腱和胫骨前肌腱以及跟腱。休闲球员和精英足球运动员都会发生急性跟腱断裂。胫骨前端摩擦综合征可能会模仿胫骨应力性骨折。职业足球运动员踝关节急性外伤和慢性过度运动损伤的长期后遗症表现为踝关节骨关节炎,不仅比普通人群更常见,而且比其他运动项目的前精英运动员更常见。本文按受伤频率排序,探讨了足球运动中最常见和最特殊的损伤。
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引用次数: 0
Location of medial collateral ligament tears: introduction to a magnetic resonance imaging-based classification. 内侧副韧带撕裂的位置:基于磁共振成像的分类介绍。
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-04-01 Epub Date: 2024-07-31 DOI: 10.1007/s00256-024-04747-8
Fidelius von Rehlingen-Prinz, Karthik R Krishnan, Sebastian Rilk, Fabian Tomanek, Gabriel C Goodhart, Victor Beckers, Robert O'Brien, Gregory S DiFelice, Douglas N Mintz

Purpose: Despite established tear grade classifications, there is currently no radiological classification for sMCL tear locations. This study aims to establish a magnetic resonance imaging (MRI) tear location classification system for sMCL tears, to enhance understanding and guide treatment decisions by categorizing tear types.

Methods: A retrospective search in a single institution's MRI database identified patients with acute, Grade III sMCL tears (< 30 days between injury and MRI) from January to December 2022. Non-acute and partial tears were excluded, and three observers assessed tear types based on the proposed sMCL MRI tear location system: type I (proximal 25%), Ib (proximal femoral bony avulsion), II (midsubstance, 25-75%), III (distal 25%), IIIb (distal tibial bony avulsion), IIIs (Stener-like lesion). The interclass correlation coefficient (ICC) was used to assess interrater and intrarater reliability for continuous data; Fleiss and Cohen's kappa assessed interrater and intrarater reliability for categorical data.

Results: MRI scans of thirty patients with diagnosed sMCL injuries (53% female, mean age 37 ± 13 years, range 16-68 years) were included based on inclusion/exclusion criteria. Interrater reliability was excellent (ICC: 0.968, 95% CI, 0.933-0.985), and intrarater reliability was excellent (ICC: 0.938, 95% CI: 0.874-0.970 & 0.900, 95% CI, 0.789-0.952). Type I injuries were most common (60%), followed by type III (33.3%), type II (3.3%), type Ib (3.3%), type IIIb (0.0%), and type IIIs (0.0%).

Conclusion: The presented MRI-based sMCL tear location classification provides a reproducible system for grading high-grade sMCL injuries. We propose that this framework will significantly unify tear location understanding and support more informed treatment decisions.

目的:尽管已经建立了撕裂等级分类,但目前还没有针对sMCL撕裂位置的放射学分类。本研究旨在为 sMCL 撕裂建立一个磁共振成像(MRI)撕裂位置分类系统,通过对撕裂类型进行分类,加深理解并指导治疗决策:方法:在一家医疗机构的磁共振成像数据库中进行回顾性检索,确定急性 III 级 sMCL 撕裂症患者(结果:30 名患有急性 III 级 sMCL 撕裂症的患者接受了磁共振成像扫描:根据纳入/排除标准,纳入了 30 名确诊为 sMCL 损伤的患者(53% 为女性,平均年龄为 37 ± 13 岁,年龄范围为 16-68 岁)的 MRI 扫描结果。研究者之间的可靠性极佳(ICC:0.968,95% CI,0.933-0.985),研究者内部的可靠性也极佳(ICC:0.938,95% CI:0.874-0.970 & 0.900,95% CI,0.789-0.952)。I型损伤最常见(60%),其次是III型(33.3%)、II型(3.3%)、Ib型(3.3%)、IIIb型(0.0%)和IIIs型(0.0%):结论:所提出的基于磁共振成像的 sMCL 撕裂位置分类法为分级高级别 sMCL 损伤提供了一个可重复的系统。我们认为,这一框架将极大地统一对撕裂位置的认识,并支持更明智的治疗决策。
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引用次数: 0
Maturation-dependent patterns of knee injuries among symptomatic pediatric soccer players on MRI. 核磁共振成像显示有症状的儿童足球运动员膝关节损伤的成熟依赖模式。
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-04-01 Epub Date: 2023-12-28 DOI: 10.1007/s00256-023-04543-w
Vandan Patel, Jude Barakat, Lewis Fanney, Liya Gendler, Naomi J Brown, Theodore J Ganley, Jie C Nguyen

Objective: To systematically investigate the prevalence of knee MRI findings among symptomatic pediatric soccer players with respect to skeletal maturity and to identify predictors of surgery.

Methods: This IRB-approved, HIPAA-compliant retrospective study included soccer players (< 18 years of age) who underwent MRI examinations in the past 5 years (2018-2023). Two radiologists retrospectively and independently reviewed all examinations to categorize skeletal maturity and to identify osseous and soft tissue findings. Findings were compared between maturation groups, and logistic regression models were used to identify predictors of surgery.

Results: Ninety-seven players (45 boys, 52 girls) included 39 skeletally immature, 21 maturing, and 37 mature knees. Kappa coefficient for interobserver reliability ranged between 0.65 and 1.00. Osgood-Schlatter disease (OSD) was more common among immature than maturing and mature knees (25% vs 14% and 5%, p = 0.04); anterior cruciate ligament (ACL) injury was more common among maturing and mature than immature knees (59% and 48%, vs 15%, p < 0.01); and meniscal tears were more common among mature than immature and maturing knees (medial, 41% vs 18% and 14%, p = 0.03; lateral, 43% vs 21% and 19%, p = 0.04). Players in the mature group were more likely to undergo surgery (p = 0.01). The presence of an effusion (OR = 19.5, 95% CI 2.8-240.9, p = 0.01), ACL injury (OR = 170.0, 95% CI 1.3-6996.9, p < 0.01), and lateral meniscal tears (OR = 10.8, 95% CI 1.8-106.1, p = 0.02) were independent predictors of surgery.

Conclusion: Differential patterns of injury were found among symptomatic pediatric soccer players; the presence of an effusion, ACL injury, and lateral meniscal tears were independent predictors of surgery, likely contributing to the higher rates of surgery among skeletally mature players.

目的系统研究有症状的儿童足球运动员膝关节 MRI 检查结果的发生率与骨骼成熟度的关系,并确定手术的预测因素:这项经 IRB 批准、符合 HIPAA 标准的回顾性研究纳入了足球运动员(结果:97 名球员(45 名男孩,1 名男孩,1 名男孩):97名球员(45名男孩,52名女孩)包括39个骨骼不成熟的膝关节、21个成熟的膝关节和37个成熟的膝关节。观察者间可靠性的卡帕系数介于 0.65 和 1.00 之间。未发育成熟的膝关节比发育成熟的膝关节更常见奥斯古德-斯克拉特病(OSD)(25% vs 14% 和 5%,P = 0.04);发育成熟的膝关节比未发育成熟的膝关节更常见前交叉韧带损伤(59% 和 48% vs 15%,P < 0.01);半月板撕裂比未发育成熟的膝关节更常见。01);半月板撕裂在成熟膝关节中比未成熟膝关节和成熟膝关节中更常见(内侧,41% vs 18% 和 14%,p = 0.03;外侧,43% vs 21% 和 19%,p = 0.04)。成熟组的球员更有可能接受手术治疗(P = 0.01)。积液(OR = 19.5,95% CI 2.8-240.9,p = 0.01)、前交叉韧带损伤(OR = 170.0,95% CI 1.3-6996.9,p < 0.01)和外侧半月板撕裂(OR = 10.8,95% CI 1.8-106.1,p = 0.02)是手术的独立预测因素:结论:在有症状的儿童足球运动员中发现了不同的损伤模式;存在积液、前交叉韧带损伤和外侧半月板撕裂是手术的独立预测因素,这可能是骨骼发育成熟的球员手术率较高的原因。
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引用次数: 0
Management of radiology services during the 2022 FIFA football (soccer) World Cup. 2022年国际足联足球世界杯期间的放射科服务管理。
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-04-01 Epub Date: 2023-11-09 DOI: 10.1007/s00256-023-04486-2
Marcelo Bordalo, Toni Evans, Salwa Allenjawi, Stephen Targett, Peter Dzendrowskyj, Abdulaziz Jaham Al-Kuwari, Marco Cardinale, Pieter D'Hooghe

Diagnostic imaging is the predominant medical service sought for the assessment and staging of musculoskeletal injuries in professional sports events. During the 2022 FIFA Football (soccer) World Cup, a centralized medical care infrastructure was established. This article provides a comprehensive account of the radiological services implemented during this event, encompassing the deployment of equipment and human resources, the structuring of workflows to uphold athlete confidentiality, and initiatives aimed at enhancing communication. Communication channels were refined through radiology consultations held with national teams' health care providers and the adoption of audiovisual reports available in multiple languages, which could be accessed remotely by team physicians. Our established framework can be replicated in international professional football events for seamless integration and efficacy.

诊断成像是专业体育赛事中评估和分期肌肉骨骼损伤的主要医疗服务。在2022年国际足联足球世界杯期间,建立了集中医疗基础设施。本文全面介绍了此次活动期间实施的放射服务,包括设备和人力资源的部署、维护运动员保密的工作流程结构,以及旨在加强沟通的举措。通过与国家团队的医疗保健提供者进行放射学咨询,并采用多种语言的视听报告,团队医生可以远程访问这些报告,完善了沟通渠道。我们建立的框架可以在国际职业足球赛事中复制,以实现无缝集成和高效性。
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引用次数: 0
Groin pain in soccer players: anatomy, clinical presentation, biomechanics, pathology and imaging findings. 足球运动员的腹股沟疼痛:解剖学、临床表现、生物力学、病理学和影像学发现。
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-04-01 Epub Date: 2024-05-24 DOI: 10.1007/s00256-024-04699-z
Julia Calatayud Moscoso Del Prado, María Ángeles Fernández-Gil, Ángel Bueno Horcajadas, Ara Kassarjian

Groin pain is extremely common in soccer players, especially male soccer players, with nearly a third experiencing groin pain over the course of their careers. Despite its high prevalence, there continues to be some confusion and controversy regarding the detailed anatomy and recommended terminology related to groin pain in athletes. This article will review the anatomy, clinical presentation, biomechanics, pathology and imaging findings most commonly associated with groin pain in soccer players.

腹股沟疼痛在足球运动员,尤其是男性足球运动员中极为常见,近三分之一的运动员在其职业生涯中会出现腹股沟疼痛。尽管腹股沟疼痛的发病率很高,但关于运动员腹股沟疼痛的详细解剖结构和推荐术语仍然存在一些混淆和争议。本文将回顾与足球运动员腹股沟疼痛最常见相关的解剖学、临床表现、生物力学、病理学和影像学检查结果。
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引用次数: 0
Non-osseous coalition of accessory anterolateral talar facet-A case series. 距骨前外侧附属面的非骨性联合--病例系列。
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-04-01 Epub Date: 2024-09-02 DOI: 10.1007/s00256-024-04781-6
Jatinder Pal Singh, Sahil Loomba, Bishika Pun, Somesh Virmani

The accessory anterolateral talar facet (AALTF) is an anatomical variation that broadens the apex of the lateral talar process. Studies have associated it with other tarsal coalitions as a cause of rigid painful flatfoot. However, a coalition of an AALTF has never been described before. With the advent of MRI, there has been an increase in the detection of these accessory facets. Nevertheless, owing to its small size and unfamiliarity, it is not easily identified. Proper assessment of imaging findings and associated conditions is needed to confirm the diagnosis. Imaging findings in a series of four patients with painful rigid flatfoot revealed the presence of an AALTF with adjacent marrow edema and reduced joint space. This was associated with hindfoot valgus and subfibular impingement. Radiographic suspicion of a non-osseous coalition of AALTF was raised, which was confirmed intraoperatively in one of the patients and demonstrated on CT and MR images in the other patients. This case series presents rare cases of non-osseous coalition of AALTF with a new radiographic sign, the 'reverse tip of the iceberg sign'.

距骨前外侧附加面(AALTF)是一种解剖变异,它扩大了距骨外侧突的顶点。研究表明,它与其他跗骨联合是导致僵硬性疼痛性扁平足的原因之一。然而,AALTF联合之前从未被描述过。随着核磁共振成像技术的出现,这些附属面的检测率有所提高。然而,由于其体积小且不熟悉,并不容易识别。需要对成像结果和相关情况进行正确评估,才能确诊。在对四名患有疼痛性僵硬扁平足的患者进行的一系列影像学检查中发现,AALTF伴有邻近骨髓水肿和关节间隙缩小。这与后足外翻和腓骨下撞击有关。其中一名患者在术中证实了这一点,其他患者的 CT 和 MR 图像也证实了这一点。本病例系列介绍了AALTF非骨性联合的罕见病例,并给出了一种新的影像学征象--"反向冰山一角征"。
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引用次数: 0
Medial femoral condyle OCD (osteochondritis dissecans): correlation between imaging and arthroscopy. 股骨内侧髁OCD(骨软骨炎):影像学检查和关节镜检查之间的相关性。
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-04-01 Epub Date: 2024-08-13 DOI: 10.1007/s00256-024-04749-6
Jie C Nguyen, Vandan Patel, Liya Gendler, Donna G Blankenbaker, Kevin G Shea, Eric J Wall, James L Carey, Carl W Nissen, Diego Jaramillo, Theodore J Ganley

Osteochondritis dissecans (OCD) describes a pathologic condition centered at the osteochondral junction that may result in an unstable subchondral fragment (progeny), disruption of the overlying cartilage, which may separate from the underlying parent bone. It is one of the causes of chronic knee pain in children and young adults. The current literature on OCD lesions focuses primarily on the medial femoral condyle (MFC), but inconsistent use of terminology, particularly in the distinction of OCD lesions between skeletally immature and mature patients has created uncertainty regarding imaging workup, treatment, and long-term prognosis. This article reviews the pathophysiology of MFC OCD lesions, highlighting the role of endochondral ossification at the secondary growth plate of the immature femoral condyles, the rationale behind the imaging work-up, and key imaging findings that can distinguish between stable lesions, unstable lesions, and physiologic variants. This overview also provides a case-based review to introduce imaging correlates with the ROCK (Research in Osteochondritis of the Knee) arthroscopic classification.

骨软骨炎(Osteochondritis dissecans,OCD)是一种以骨软骨交界处为中心的病理状态,可能导致不稳定的软骨下碎片(后代)、上覆软骨的破坏,并可能与下层母骨分离。这是导致儿童和青少年慢性膝关节疼痛的原因之一。目前有关 OCD 病变的文献主要集中在股骨内侧髁 (MFC),但术语的使用并不一致,尤其是在区分骨骼未成熟和成熟患者的 OCD 病变时,造成了影像学检查、治疗和长期预后方面的不确定性。本文回顾了MFC OCD病变的病理生理学,强调了未成熟股骨髁次生生长板软骨内骨化的作用、影像学检查的基本原理以及可区分稳定病变、不稳定病变和生理学变异的关键影像学发现。本概述还以病例为基础,介绍了影像学与 ROCK(膝关节骨软骨炎研究)关节镜分类的相关性。
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引用次数: 0
Youth soccer players: patterns of injury involving the primary growth plates of epiphyses. 青少年足球运动员:涉及骨骺初级生长板的损伤模式。
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2025-04-01 Epub Date: 2024-01-04 DOI: 10.1007/s00256-023-04541-y
Jie C Nguyen, Dennis Caine

Youth soccer (football) is immensely popular internationally. Earlier participation, sport sub-specialization, and year-around practice have led to an increased incidence of injury from both acute trauma and repetitive overuse. The growth plates (physes) of the immature skeleton are particularly vulnerable to injury and delayed diagnosis can lead to future growth disturbance and long-term morbidity. Familiarity with the various components of the growth plate complex necessary for ensuring normal endochondral ossification is fundamental in understanding the various patterns of imaging findings following injury. This review discusses the zonal columnar arrangement of the growth plate proper and the contrasting function of the vasculature within the subjacent epiphysis and metaphysis. This is followed by an evidence-based discussion of the common patterns of injury involving the epiphyseal primary growth plate observed among youth soccer players: subcategorized into physeal fractures (direct injury) and physeal stress injuries (indirect insult to subjacent metaphysis). In this section, the role of imaging and characteristic imaging features will be discussed. While the normal physiologic and pathophysiologic mechanisms can be applied to other growth plates, such as primary growth plates underlying the apophyses and secondary growth plates surrounding the secondary ossificiation centers, which also undergo endochondral ossification, the current review is focused on injuries involving the primary growth plates underlying epiphyses.

青少年足球在国际上非常流行。较早的参与、运动的亚专业化和全年的练习导致急性创伤和重复过度使用造成的损伤发生率增加。未成熟骨骼的生长板(骺板)特别容易受伤,延误诊断会导致未来生长障碍和长期发病。熟悉确保软骨内骨化正常所必需的生长板复合体的各个组成部分,对于理解损伤后的各种影像学结果模式至关重要。本综述将讨论生长板本体的带状柱状排列以及邻近骨骺和骨骺内血管的对比功能。随后,以证据为基础讨论了青少年足球运动员骺板初级生长板常见的损伤模式:分为骺板骨折(直接损伤)和骺板应力损伤(间接损伤邻近的干骺端)。本节将讨论成像的作用和成像特征。虽然正常的生理和病理生理学机制可应用于其他生长板,如骨骺下的初级生长板和继发性骨化中心周围的次级生长板(它们也会发生软骨内骨化),但本综述的重点是涉及骨骺下初级生长板的损伤。
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引用次数: 0
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Skeletal Radiology
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