强直性髋关节炎平片与MRI分析  

Analysis of radiographic signs in ankylosing arthritis of hip

作　　者：晁小海 宋新春[1] 王云钊[2] 

机构地区：[1]北京北亚骨科医院,北京100102 [2]北京积水潭医院,北京100035

出　　处：《中国中西医结合影像学杂志》2008年第4期244-246,共3页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:分析强直性髋关节炎骨盆骨质疏松的细微结构和骨坏死的病理性征象。方法:收集北亚骨科医院强直性脊柱炎患者100例,其中8例行MR成像检查。分析髋部骨质疏松的特殊性和骨坏死征象以及关节软骨破坏程度。结果:髋部多发区域性骨小梁丢失、减少发生率最高85%,骶髂关节侵蚀破坏或骨性强直为100%,股骨头灶性骨坏死,吸收后表现单囊或多囊状破坏或有小死骨34%,关节破坏狭窄54%,股骨头关节软骨边缘滑膜骨化突出33%,耻骨联合吸收或硬化24%,坐骨结节骨化43%。结论:强直性髋关节炎主要表现为区域性迁移骨疏松和股骨头多发灶性骨坏死。Objective： To analyze the fine details of osteoporosis and pathologic signs of osteonecrosis of pelvis in ankylosing arthritis of the hip. Methods： One hundred cases of ankylosing spondylitis in Beiya hospital were studied, of which 90 were male and 8 female with a ratio of 12.5.1. The onset age of the disease was from 13 to 49 years with an average of 31 years. 98 cases were involved in bilateral affection. Chief clinical symptoms included gerneral weakness, fever and pain in low back, sacroiliac and hip regions. The osteoporosis and osteonecrosis in the hip regions were analysed as well as the joint cartilage destruction, compared to the changes in hormone therapeutic osteonecrosis. Results： Multiple regional trabecular rarefaction was found in 85% cases. Erosion, destruction or ankylosis occurred in 100%. Focal osteonecrosis of the femoral head showed monoor multi-cystic destruction with minimal sequestrum in 34 %. Joint destruction and narrowing were found in 54 %. Marginal synovial protruding ossification near the joint cartilage of the femoral head was found in 33%. Resorption of symphysis pubis of sclerosis and ossification of ischial tuberrosity at the attachment of adductor major were found in 24% and 43% respectively. Conclusion： Regional migrating osteoporosis and multiple focal osteonecrosis in the femoral head are the main radiogrphic sign of ankylosing arthritis of the hip.

关 键 词：强直性脊柱炎 髋关节炎 骨坏死 X线平片 MR成像 

分 类 号：R593.23[医药卫生—内科学] R445[医药卫生—临床医学]