髋臼发育不良患者髋臼盂唇内翻的影像学特征及临床意义  

Radiological and Clinical Features of Inverted Labrum in Young Adult Hips with Dysplasia

作　　者：罗殿中[1] 张洪[1] 张伟佳[1] 温博[2] 罗金涛[2] 

机构地区：[1]解放军总医院第一附属医院关节与运动损伤病区,北京100048 [2]解放军总医院第一附属医院放射科,北京100048

出　　处：《实用骨科杂志》2013年第7期598-601,共4页Journal of Practical Orthopaedics

摘　　要：目的通过临床研究报告青少年及成人髋臼发育不良患者髋臼盂唇内翻的影像学特征及临床意义。方法 2010年10月至2012年11月,对248例青少年及成人髋臼发育不良及髋关节半脱位患者行骨盆X线、髋关节核磁造影检查,发现12髋存在典型关节内盘状软骨样结构,均为女性,年龄9～36岁,平均17.8岁,左侧5髋,右侧7髋;并通过髋关节切开清理,得到大体标本及病理证实。结果青少年及成人髋臼盂唇内翻的X线片特点是髋臼负重区短小,部分软骨下骨模糊、欠规则;直接核磁造影片上内翻盂唇呈线条样低信号衬于髋臼与股骨头之间。其病理结构为纤维软骨。青少年及成人髋臼盂唇内翻多见于女性、较严重髋关节发育不良或半脱位,较早出现髋关节疼痛。绝大部分患髋4字试验阳性,部分患侧髋关节前内侧撞击试验或后外侧撞击试验阳性。其预后及临床意义值得探讨。结论典型青少年及成人髋臼盂唇内翻有明显的X线片和髋关节核磁特征,其临床特征、预后及意义需进一步研究。Objective To analyze radiological and clinical features of inverted labrum in young adult hips with acetabular dysplasia. Methods From October 2010 to November 2012,248 young adult hips with acetabular dysplasia underwent X-rays ,direct magnetic resonance arthrography （dMRA）. 12 hips （5 left, 7 right） appeared typical inverted labrum,which were verified during operation. All were females, 9~ 36 years old,meaning 17.8ys. The specimens were pathologically checked. Results The x-ray of the young adult hips with inverted labrum showed shortness of the ac- etabular burden zone,subchondral bone irregular. On the dMRA films low signal liner located between the femoral head and the acetabular,which was continuous with the margin of acetabular labrum and acetabular rim. Pathological result was fibrocartilage. Inverted labrum occurred in young females with acetabular dysplasia or subluxation, with early hip pain,positive 4 test,positive impingement test. Conclusion Typical inverted labrum of young adult hips with dysplasia has obvious characteristic features on x-ray and dMRA films,but the clinical features and prognosis need further research.

关 键 词：髋臼发育不良 髋臼盂唇内翻 影像学特征 

分 类 号：R682.17[医药卫生—骨科学]