强直性脊柱炎髋关节损害的临床与X线诊断

THE CLINICAL AND RADIOLOGICAL DIAGNOSIS OF HIP DAMAGE IN ANKYLOSING SPONDYLITIS

为探讨强直性脊柱炎髋关节损害的X线诊断要点,提高对其X线表现的认识。将43例强直性脊柱炎髋关节(79个)损害的所有X线征象列出,对每一征象在髋关节上出现的频率进行统计分析。结果显示79个髋关节X线表现出现的频率依次为:股骨头囊变破坏(60/79),髋臼增生软骨下囊性变(56/79),髋关节间隙狭窄(51/79),髋关节间隙均匀性狭窄(48/79),股骨头增大(44/79),股骨头基部外侧孤立性骨赘(44/79),骨盆骨炎(19/43),股骨头皮质侵蚀破坏(19/79),股骨头关节面边缘骨赘形成(14/79),股骨头内见条片状硬化(13/79),股骨头密度减低(8/79)。表明强直性脊柱炎髋关节损害多表现为股骨头囊变破坏、髋臼增生、软骨下囊性变、髋关节间隙均匀性狭窄、股骨头增大、股骨头基部外侧孤立性骨赘及骨盆骨炎等。上述X线表现有一定特征性,认识这些表现,对于强直性脊柱炎髋关节损害的临床诊断、鉴别诊断和治疗有一定价值。

The objective of the paper is to explore the main points of the X-ray diagnosis of hip damage in ankylosing spondylitis (HDAS) and to improve the knowledge of the X-ray findings. All the X-ray signs of 43 cases (79 hips) of HDAS were listed and the frequency of each sign appearing in the hips was counted and analyzed. The results showed that the X-ray findings of the 43 cases (79 hips) included: cystic degeneration destruction of the femoral head (60/79), acetabulum proliferation and subchondral cystic degeneration (56/79), hip space stenosis (51/79), hip space even stenosis (48/79), enlargement of the femoral head (44/79), solitary osteophyte in the lateral femoral head basis (44/79), pelvic ostitis (19/79), erosive destruction of the femoral head (19/79), osteophyte appearing in the border of the femoral-head articular surface (14/79), streak-patchy osteosclerosis in the femoral head (13/79), femoral head density decrease (8/79), suggesting that HDAS are manifested mostly by: cystic degeneration destruction of the femoral head, acetabulum proliferation and subchondral cystic degeneration, even hip space stenosis, enlargement of the femoral head, solitary osteophyte in the lateral femoral head basis and pelvic ostitis. The above-mentioned X-ray findings may be regarded as the unique characteristics of HDAS; the knowledge of these findings has some value for the clinical and differentiation diagnosis and treatment of HDAS.