X线片测量髌骨外倾角在髌股关节病诊断中的应用  

Application of patella tilting angle on X-ray image in diagnosis of patellofemoral arthropathy

作　　者：孔庆波[1] 李宝林[1] 陈福来[2] 赵巍[1] 马立学[1] 崔国庆[3] Kong Qingbo;Li Baolin;Chen Fulai;Zhao Wei;Ma Lixue;Cui Guoqing(Department of Orthopedics,the First Hospital of Harbin,Harbin 150010,China;Department of Radiology,the First Hospital of Harbin,Harbin 150010,China;Institute of Sports Medicine,the Third Hospital of Peking University,Beijing 100191,China)

机构地区：[1]哈尔滨市第一医院骨外科,150010 [2]哈尔滨市第一医院放射科,150010 [3]北京大学第三医院运动医学研究所,100191

出　　处：《中华关节外科杂志（电子版）》2018年第3期421-423,共3页Chinese Journal of Joint Surgery(Electronic Edition)

基　　金：黑龙江省卫生厅科研课题(2011-519)

摘　　要：目的观察髌股关节病患者,髌骨外倾角的大小范围对髌股关节病诊断的意义。方法实验组收集年龄27~65岁,平均年龄(50±4)岁。临床上就诊于哈尔滨市第一医院骨科患者,不同程度的膝关节疼痛及屈伸活动受限,排除类风湿性关节炎,关节感染,关节外伤,符合髌股关节病诊断标准病例214例,共计214膝。拍摄X光下膝关节屈膝髌骨30°时轴位片,测量髌骨外倾角的大小。对照组收集年龄28~77岁,平均年龄(51±3)岁,无膝关节病及疼痛的病例60例,共计60膝,拍摄X光下膝关节屈膝髌骨30°时轴位片,测量髌骨外倾角的大小。结果实验组测得髌骨外倾角在18.5°~35.2°之间,髌股关节病患者X光下膝关节屈膝髌骨30°时轴位片髌骨外倾角增大。对照组测得髌骨外倾角在7.7°~18.7°之间,X光下膝关节屈膝髌骨30°时轴位片髌骨外倾角在正常范围。结论髌骨外倾角的测量对于髌股关节病的诊断有重要意义,X光下膝关节屈膝髌骨30°时轴位片见髌骨外倾角增大并伴有关节疼痛患者可以考虑髌股关节病诊断,可行关节镜手术治疗。Objective To observe the diagnostic significance of range of the patella tilting angle in patients with patellofemoral disease. Methods In the orthopedic department of the First Hospital of Harbin,214 cases of 214 knees diagnosed as patellofemoral joint disease with knee pain and limited flexion activities were enrolled to the experimental group,among whom rheumatoid arthritis,joint infection or joint injury was excluded. The age of experimental group was from 27 to 65 years,with an average age of（ 50 ± 4） years. The control group enrolled 60 cases of 60 knees without knee joint diseases or pain. The age of control group was28 to 77 years,（ 51 ± 3） years on average. X-ray image of knee-patella at 30 ° knee-flexion axial position was used to measuring the size of the patella tilting angle. Results The patella tilting angle of the experimental group was between 18. 5 ° and 35. 2 °; the patella tilting angle increased at 30 ° knee-flexion axial position in X-ray image. The patella tilting angle of the control group was between 7. 7 ° and 18. 7 °,which was in the normal range. Conclusion Patella tilting angle measurement has important significance for patellofemoral joint disease diagnosis; when it increases at 30 ° knee-flexion axial position in X-ray with joint pain,the patient may be diagnosed joint disease and arthroscopic treatment can be performed.

关 键 词：髌骨 髌股关节 关节疾病 X线 

分 类 号：R684[医药卫生—骨科学] R816.8[医药卫生—外科学]