下肢全长负重位X线检查在膝关节炎内外翻畸形中的临床价值  

Clinical Value of Knee Arthritis for Knee Varus or Valgus Deformity with Full-Length Weight-Bearing X-Ray of Lower Limbs

作　　者：沈钰[1] 董丰琴 朱艺 余景武[1] 苏佩华 俞立新[3] Shen Yu;Dong Fengqin;Zhu Yi;Yu Jingwu;Su Peihua;Yu Lixin(Department of RadiolooyThe 72st Group Army Hospital of the Chinese People's Liberation A any(Huzhou,Zhejiang 313000;Department of First OrthopedicsThe 72st Group Army Hospital of the Chinese People's Liberation A any(Huzhou,Zhejiang 313000;Department of Third Orthopedics The 72st Group Army Hospital of the Chinese People's Liberation A any(Huzhou,Zhejiang 313000)

机构地区：[1]中国人民解放军陆军第72集团军医院放射科,浙江湖州313000 [2]中国人民解放军陆军第72集团军医院骨一科,浙江湖州313000 [3]中国人民解放军陆军第72集团军医院骨三科,浙江湖州313000

出　　处：《现代医用影像学》2020年第3期402-406,共5页Modern Medical Imageology

摘　　要：目的:探讨膝关节炎患者下肢全长负重位X线片对膝内、外翻畸形诊断的临床价值。方法:选取32例临床诊断为膝关节炎51膝分别拍摄下肢全长负重X线片,测量下肢力线和机械轴偏距(mechanical axis offset distance,MAD),解剖学股胫骨角(anatomical femor-tibial angle,aFTA),股骨远端力学外侧角(mechanical lateral distal femoral angle,mLDFA),胫骨近端力学内侧角(mechanical medial proximal tibial angle,mMPTA),对图像数据进行分析,对膝关节炎进行X线K/L分级,通过SPSS 17.0统计对下肢力线各参数与关节炎的相关性进行分析。结果:①膝关节下肢全长负重位X线片显示,关节有不同程度骨质增生,关节间隙变窄。②51膝骨关节炎中确诊膝内翻畸形38膝(74.51.%)和膝外翻畸形8膝(10.42%),5膝均无内外翻畸形。③膝关节炎X线K/L分级显示,0级:5膝(9.8%),I级:12膝(23.5%),II级:22膝(43.1%);III级:9膝(17.6%);IV级:3膝(59%)。④膝内翻组中股骨内翻7膝(18.42%),胫骨内翻18膝(47.36%),股骨、胫骨均内翻13膝(34.21%);膝外翻组中股骨外翻6膝,股骨、胫骨均外翻2膝。⑤在膝内翻组中,aFTA与骨关节炎X线K/L分级呈正相关(B值=0.132,t=2.648,P=0.012,P<0.05)。结论:下肢全长负重X线显示下肢结构清晰、完整,通过测量下肢力线参数评估,可全面诊断膝关节炎的内翻畸形或外翻畸形,膝内翻中以胫骨内翻显著,膝外翻中则以股骨外翻显著。因此,膝关节骨性关节炎的下肢全长负重X线检查具有较高的临床价值。Objective:To investigate the clinical value of full-length weight-bearing X-ray examination of lower limbs in knee osteoarthritis for knee varus or knee valgus deformity.Methods:51 knee joints of 32 patients diagnosed as osteoarthritis of knee joint were studied. The gastrointestinal-DR integrated X-ray examination equipment was used to take the full-length weight-bearing X-ray film of the affected limb, and the lower limb force line and mechanical axis offset distance(MAD),anatomical femor-tibial angle(aFTA),mechanical medial proximal tibial angle(mMPTA),mechanical lateral distal tibial angle(mLDFA) were measured, and the image data were analyzed and evaluated. To assessed the knee osteoarthritis by X-ray grading of the Kellgren-Lawrence criteria,and was performed on correlation between the parameters of lower limb alignment and knee osteoarthritis analysis by SPSS 17.0.Results:①The full-length weight-bearing X-ray films of 51 knees showed, all the knees had different degrees of hyperosteogeny and the joint space became narrow.②38 cases(74.51.%)of knee varus deformity and 8 cases(10.42%)of knee valgus deformity in 51 cases of knee osteoarthritis were confirmed, 5 cases of knees neither varus deformity also didn’t valgus deformity. ③Knee osteoarthritis by X-ray K/L criteria were 5 cases(9.8%)with Grade 0, 12 cases(23.5%)with Grade I, 22 cases(43.1%)with Grade II, 9 cases(17.6%)with Grade III, 3 cases(5.9%)with Grade IV.④In knee varus deformity group, the femoral varus were 7 knees(18.42%), the tibial varus were 18 knees(47.36%), both femora and tibial were varus with 13 knees(34.21%).In knee valgus deformity group, the femoral valgus were 6 knees, both femora and tibial were valgus with 2 knees.⑤In the knee varus group, aFTA was positively correlated with the X-ray K/L grade of osteoarthritis(B=0.132, t=2.648, P=0.012, P<0.05).Conclusion:The full full-length weight-bearing x-ray display of lower extremity is not only clear but also complete. The diagnosis of varus or valgus deformity of knee arthritis

关 键 词：下肢全长x线 负重位 膝关节炎 膝内翻 膝外翻 

分 类 号：R684.3[医药卫生—骨科学] R816.8[医药卫生—外科学]