单侧股骨头缺血坏死的双侧坐骨股骨间隙对比分析

Comparative Analysis of Bilateral Ischiofemoral Space in Unilateral Femoral Head Necrosis

目的探讨单侧股骨头缺血坏死(ONFH)患者双侧髋关节坐骨股骨间隙(IFS)的变化情况。方法回顾性分析39例单侧ONFH患者的髋关节MRI图像,轴位T1WI上测量双侧髋关节的IFS、股方肌间隙(QFS),轴位T2WI上观察双侧股方肌形态及水肿程度,判断是否合并坐骨股骨撞击综合征(IFI)。应用配对t检验检测双侧髋关节间IFS、QFS的差别,应用卡方检验检测双侧髋关节IFI发病率的差别。结果39例患者,共78个髋关节,男23例,女16例,年龄28~82岁。股骨头正常侧的IFS(22.4±8.7 mm)、QFS(16.8±7.9mm)小于股骨头坏死侧的IFS(25.9±5.8mm)、QFS(19.6±6.3mm)(P<0.05);股骨头正常侧髋关节伴发IFI者12例(30.7%),股骨头坏死侧髋关节伴发IFI者3例(7.7%),双侧髋关节同时发病者1例(2.6%),股骨头正常侧髋关节IFI的发病率明显高于坏死侧。结论单侧ONFH患者中股骨头正常侧髋关节更容易伴发IFI。

Objective To investigate the change of ischiofemoral space of bilateral hip joints in patients with unilateral osteonecrosis of the femoral head(ONFH).Methods The MR images of 39 patients with unilateral ONFH were retrospectively analyzed.The ischiofemoral space(IFS)and quadratus femoris space(QFS)of bilateral hip joints were measured on the transverse T1WI.The morphology and degree of edema of bilateral femoral muscles were analysed on the transverse T2WI to determine whether IFI was complicated.The difference of IFS and QFS in bilateral the hip joints were compared by paired t test and the incidence of IFI in bilateral hip joints was compared with chi-square test.Results 39 patients had 78 hip joints,including 23 males and 16 females,aged 28-82 years.The IFS(22.4±8.7 mm)and QFS(16.8±7.9 mm)on the normal side of the femoral head were smaller than the IFS(25.9±5.8 mm)and QFS(19.6±6.3 mm)on the normal side of the femoral head,P<0.05;There were 12 cases(30.7%)with IFI on the hip joint,3 cases(7.7%)with IFI on the hip joint with the femoral head necrosis,1 case(2.6%)with both hip joints,and the hip joint on the normal side of the femoral head.The incidence of IFI was significantly higher than that of the necrotic side.Conclusion In patients with unilateral avascular necrosis of the femoral head,the hip joint on the normal side of the femoral head is more likely to be accompanied by IFI.