股骨头囊性变的鉴别诊断  

The Differential Diagnosis of Cystic Change in Femur Head

作　　者：邢立峰 周玲玲[2] 王颖 修晓光 

机构地区：[1]青岛市海慈医疗集团骨科,山东青岛266033 [2]青岛市肿瘤医院内科

出　　处：《中国中医骨伤科杂志》2011年第9期45-47,共3页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：青岛市科技局资助项目;编号:08-2-1-7-nsh

摘　　要：目的：分析股骨头囊性变（cystic change of femoral head,CCFH）的临床及影像学特点,提出其鉴别诊断方法。方法：回顾性分析自1996年6月~2010年6月所诊治的CCFH病例49例（均经病理或随随访确诊）,男28例,女21例;年龄13~62岁,平均年龄38.2岁;ARCOⅡ期股骨头坏死（osteonecrosis of femoral head,ONFH）24例,原发性髋骨性关节炎囊变9例,成人发育不良性髋臼发育不良囊变6例,类风湿性关节炎囊变4例,强脊性髋关节病2例,股骨头软骨母细胞瘤2例,骨内腱鞘囊囊肿1例,滑膜疝洼1例。分析其临床表现和CT及MR表现。结果：49例中2例类风湿性髋关节炎囊性变误诊为ONFH,3例原发性髋骨性关节炎误诊为ONFH,3例成人发育性髋关节发育不良误诊为ONFH,2例强脊性髋关节病误诊为ONFH,24例ONFH（ARCOⅡ期）均确诊并做出相应治治疗,1例股骨头软骨母细胞瘤以良性病变刮除不彻底术后复发行2次手术。结论：CCFH发生在诸多髋关节疾病中,易与ONFH混淆,各有其特点,应根据其临床表现和CT及MR综合考虑才能做出正确诊断,以免误诊误治。Objective：To analysis the clinical and radiographic imaging feature about cystic change of femoral head（CCFH） and raise the method for differential diagnosis.Methods： From June 1996 to June 2010,49 cases were diagnosed with CCFH by pathology or follow-up.Among them,there were 28 males and 21 females,with age ranging from 13 to 62 years（38.2 years on average）.There were 24 cases of osteonecrosis of femoral head（ONFH） ARCOstageⅡ,9 cases of primary hip osteoarthritis,6 cases of developmental dysplasia of hip arthritis,4 cases of rheumatoid arthritis,2 cases of ankylosing spondylitis,2 cases of chondroblastoma of femoral head,1 case of intraosseous ganglion,and 1 case of snovial herniation pit.We retrospectively analyzed their clinical manifestation and radiographic imaging feature of CT and MR.Results：Two patients of rheumatoid arthritis was misdiagnosed as ONFH,3 patients of primary hip osteoarthritis misdiagnosed as ONFH,3 of developmental dysplasia of hip arthritis misdiagnosed as ONFH,2 of ankylosing spondylitis misdiagnosed as ONFH.Patients of ONFH were made definite diagnosis and correct treatment.One case of chondroblastoma of femoral head received second operation for postoperative recurring result from not thoroughly erasion as benign lesion.Conclusion：CCFH exists in many hip joint diseases,and can be easily confused with ONFH.We should make a definite diagnosis according to their clinical manifestations and radiographic imaging features of CT and MR in order to avoid misdiagnosis and mistreatment.

关 键 词：囊性变 股骨头 鉴别诊断 

分 类 号：R684[医药卫生—骨科学]