强直性脊柱炎髋关节病变的早期X线征象探讨  

Early X-ray signs of hip joint lesion in ankylosing spondylitis

作　　者：强军[1] 周志宏 高万勤[1] 傅建斌[3] 李云东[1] 

机构地区：[1]河南科技大学第一附属医院放射科,河南洛阳471003 [2]洛阳铜加工厂医院放射科,河南洛阳471003 [3]河南科技大学第一附属医院风湿免疫科,河南洛阳471003

出　　处：《中国医学影像技术》2007年第1期109-111,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨强直性脊柱炎髋关节病变的早期X线征象。方法对102例强直性脊柱炎髋关节病变的X线平片进行回顾性分析。参考BathAS髋关节异常的X线分级法（BASRI—hip），分两步研究分析本组病例的X线平片表现。结果根据BASRI-hip分级法，102例强直性脊柱炎俄关节病变计188个髋关节中，1级54个髋关节，2～4级134个髋关节。此102例计188个髋关节主要X线表现为：股骨头囊变（130／188），髋臼软骨下囊变（伴或不伴髋臼增生）（128／188），髋关节间隙一致性狭窄（119／188），股骨头基部外侧孤立性骨赘（112／188），股骨头增大（101／188），髋臼骨侵蚀、白线中断（56／188），股骨大小粗隆附着病（41／102）。其中，符合BASRI—hip分级法1级标准的54个髋关节合并存在的X线征象有：髋臼骨侵蚀、白线中断（18／54），股骨头基部外侧孤立性骨赘（14／54），髋臼软骨下囊变（11／54），股骨头囊变（6／54）和股骨头密度减低（5／54）。结论强直性脊柱炎髋关节病变的早期X线征象包括：髋臼骨侵蚀、白线中断，股骨头基部外侧孤立性骨赘，髋臼软骨下囊变，股骨头囊变和股骨头密度减低；其中，髋臼骨侵蚀、白线中断，髋臼软骨下囊变和股骨头基部外侧孤立性骨赘具有一定特征性。Objective To explore the early X-ray signs of hip joint lesion in ankylosing spondylitis. Methods The plain X- ray films of 102 cases were retrospectively analyzed. According to the score of the Bath ankylosing spondylitis radiology hip index （BASRI-hip）, the X-ray features of these cases were studied and analyzed at two steps. Results According to the score of BASRI-hip, 54 hip joints were graded 1 out the 188 ones in all 102 cases, and the rest （134/188） were graded 2-4. The main X-ray findings of these 102 cases （188 hip joints） were cystic degeneration of the femoral head （130/188）, acetabulum subchondral cystic degeneration （accompanying with or without acetabulum hyperosteogeny）（128/188）, hip space even stenosis （119/188）, solitary osteophyte in the lateral femoral head basis （112/188）, enlargement of the femoral head （101/188）, acetabulum erosion and interruption of the white line （56/188）, pelvic enthesopathy （41/102）. The X-ray signs of the 54 hip joints which were graded 1 were acetabulum erosion and interruption of white line （18/54）, solitary osteophyte in the lateral femoral head basis（14/54）, acetabulum subchondral cystic degeneration （11/54）, cystic degeneration of the femoral head （6/54）, femoral head density decrease （5/54）. Conclusion The early X-ray signs of the hip joint lesion in ankylosing spondylitis were acetabulum erosion and interruption of the white line, solitary osteophyte in the lateral femoral head basis, acetabulum subchondral cystic degeneration, cystic degeneration of the femoral head, femoral head density decrease. The preceding three signs may be regarded as the unique characteristics of the hip joint lesion in ankylosing spondylitis.

关 键 词：脊柱炎 强直性 髋关节 X线 早期征象 

分 类 号：R593.23[医药卫生—内科学] R814[医药卫生—临床医学]