成人髋关节病变41例CT分析

CT Diagnosis of Hip Joint Lesions in Adults (Analysis 41 Cases)

目的:阐明成人髋关节病变的CT表现,评价其诊断价值。材料与方法:回顾分析经临床确诊或病理证实的4 1例髋关节病变的CT征象,其中退行性骨关节病1 4例,成人股骨头缺血坏死1 0例,类风湿性关节炎5例,髋关节结核4例,强直性脊柱炎累及髋关节3例,滑膜骨软骨瘤病3例,色素沉着绒毛结节性滑膜炎2例。结果:退行性骨关节病以承重区关节畸形和骨性关节面改变为主,软骨下囊变特别明显;股骨头缺血坏死显示股骨头硬化、囊变及软骨下骨折,晚期继发骨性关节炎改变;类风湿性关节炎关节间隙普遍狭窄,关节面下小囊肿周围无明显骨硬化;强直性脊柱炎累及髋关节表现为髋臼关节面锯齿状或毛刷状破坏;髋关节结核关节面广泛骨质破坏,可见到小死骨和寒性脓疡;滑膜骨软骨瘤病显示滑膜增厚和其内小钙化灶,较大的骨软骨体呈桑椹状表现;色素沉着绒毛结节性滑膜炎关节面下囊变区边缘硬化明显,关节间隙存在。结论:各种髋关节病变的CT表现不同,CT能清楚显示髋关节解剖结构及病变的部位、范围和病理解剖细节。

Purpose:To study the CT manifestations of hip joint lesions in adults and to assess their diagnostic value.Materials and Methods:CT signs in 41 cases with clinically-or pathologically-proved hip joint lesions in adults were retrospectively analyzed,The diseases included coxarthrosis in 14,avascular necrosis of the femoral head in 10,rheumatoid arthritis in 5,tuberculosis of the hip joint in 4,ankylosing spondylitis involves hip joint in 3,synovial osteochondromatosis in 3,pigmented villo nodular synovitis in 2.Results:The coxarthrosis have deformation of bearing region and change of osseous articular surface are the maior features,subchondra cyst very markedly;Avascular necrosis of the femoral head showed the lucent cystic region,sclerotic region and microfractures,later secondary osteoarthritis;Rheumatoid arthritis showed general narrowing of the joint space,subchondral small cysts and its adjacent bone sclerosis not marked;Ankylosing spondylitis involves hip joint showed the articular surface of acetabulum like serration or brush;Tuberculosis of the hip joint showed widely destruction in the articular surface,small dead bone and cold abscess visible;Synovial osteochondromatosis showed synovial thickening and small calcification,large osteochondrous body as mulberry;Pigmented villo nodular synovitis showed subchondral cyst′s edge sclerotic markedly,the joint space as well.Conclusion:Hip joint lesions in adults,due to a variety of disorders,demonstrate various CT manifestations.CT scan can clearly demonstrate the anatomy of the hip joint and location,extent and pathologic details of lesions.CT is invaluable means for the evaluation of hip joint lesions in especial monarticular arthropathies.