jktoКафедра травматологии и ортопедииDepartment of Traumatology and Orthopaedics2226-2016ПРОФИЛЬ — 2С10.17238/2226-2016-2024-2-67-74jkto-85Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWДИФФЕРЕНЦИАЛЬНАЯ ДИАГНОСТИКА АСЕПТИЧЕСКОГО (АВАСКУЛЯРНОГО) НЕКРОЗА И СТРЕСС-ПЕРЕЛОМА СЕСАМОВИДНОЙ КОСТИ (ОБЗОР ЛИТЕРАТУРЫ)DIFFERENTIAL DIAGNOSIS OF ASEPTIC (AVASCULAR) NECROSIS AND STRESS FRACTURE OF THE SESAMOID BONE (REVIEW)https://orcid.org/0009-0006-0975-5962ФаньЖулуRuluFan

Жулу Фань – аспирант кафедры травматологии, ортопедии и хирургии катастроф

119991, Москва

Rulu Fan – postgraduate Doctor of Physician, Department of Traumatology, Orthopedics and Catastrophic Surgery

119991, Moscow

tzxhfrl@163.comhttps://orcid.org/0000-0002-2202-8149ЛычагинА. В.LychaginA. V.

Алексей Владимирович Лычагин – профессор, заведующий кафедрой травматологии, ортопедии и хирургии катастроф

119991, Москва

Alexey V. Lychagin – Professor, Head of the Department of Traumatology, Orthopedics and Catastrophic Surgery, Director of the Clinic of Traumatology, Orthopedics and Joint Pathology

119991, Moscow

Lychagin7543@outlook.comhttps://orcid.org/0000-0002-1190-7498БобровД. С.BobrovD. S.

Дмитрий Сергеевич Бобров – кандидат медицинских наук, доцент кафедры травматологии, ортопедии и хирургии катастроф

119991, Москва

Dmitry S. Bobrov – Ph, Associate Professor, Department of Traumatology, Orthopedics and Catastrophic Surgery

119991, Moscow

dsbmed@mail.ruКавалерскийГ. М.KavalerskyG. M.

119991, Москва

119991, Moscow

ШубкинаА. А.ShubkinaA. A.

Алёна Александровна Шубкина – врач – травматолог-ортопед отделения медицинской реабилитации УКБ№2 клинического центра

119991, Москва

Alena A. Shubkina – PhD, doctor of trauma

119991, Moscow

alenashubkina@gmail.comФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет)РоссияFederal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russia (Sechenov University)Russian Federation202413032026026774Copyright © Фань Ж., Лычагин А.В., Бобров Д.С., Кавалерский Г.М., Шубкина А.А., 20262026Фань Ж., Лычагин А.В., Бобров Д.С., Кавалерский Г.М., Шубкина А.А.Rulu F., Lychagin A.V., Bobrov D.S., Kavalersky G.M., Shubkina A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jkto.moscow/jour/article/view/85

Цель: уточнить роль визуальной дифференциальной диагностики в выявлении асептического (аваскулярного) некроза и стресс-перелома сесамовидной кости. Методика написания обзора. Найдены 42 научные работы с использованием для поиска баз данных Cochrane Library, Scopus, PubMed по запросам: «сесамовидные кости», «асептический некроз», «аваскулярный некроз», «остеонекроз», «стресс-перелом». Для обзора отобрано 27 источников. Временной интервал анализируемой литературы: 2000–2023 гг.Заключение. Сделан вывод о важности проведения дифференциальной диагностики асептического некроза и стресс-перелома сесамовидной кости в различных локализациях. Незначительное усиление склероза, обнаруженное на компьютерной томографии, подтверждает наличие остеонекроза сесамовидной кости, тогда как неправильной формы фрагмент с плохо кортифицированными краями на рентгенограмме указывает на перелом. Радиологические исследования, включая рентгенографию, КТ и МРТ, предоставляют полезную информацию о наличии и патологии, затрагивающей эти кости, и должны использоваться совместно с клиническими данными для руководства ведением пациента.

Objective: Clarify the role of visual differential diagnosis in detecting aseptic (avascular) necrosis and stress fracture of the sesamoid bone.Review writing methodology. A total of 42 scientific papers were found using Cochrane Library, Scopus, and PubMed databases for search using the queries: "sesamoid bone", "aseptic necrosis", "avascular necrosis", "osteonecrosis", "stress fracture". Twenty-nine sources were selected for the review. The time interval of the analyzed literature: 2000-2023. Conclusion. It is concluded that it is important to perform differential diagnosis of aseptic necrosis and stress fracture of the sesamoid bone in different localizations. Slight sclerosis enhancement detected on computed tomography confirms the presence of osteonecrosis of the sesamoid bone, whereas an irregularly shaped fragment with poorly corticated edges on the radiograph indicates a fracture. Radiologic studies, including radiography, CT, and MRI, provide useful information about the presence and pathology involving these bones and should be used in conjunction with clinical findings to guide patient management.

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The authors declare that there are no conflicts of interest present.