抗维生素D佝偻病的X线表现（附一家族八例报告）

TheX┐rayfeaturesofvitaminD┐resistantrickets(reportof8casesinafamily)

目的：探讨抗维生素Ｄ佝偻病（ＶＤＲＲ）的Ｘ线表现。材料和方法：报告一家族８例ＶＤＲＲ，对该家族７例病人进行全身骨骼Ｘ线摄片观察。结果：经观察其Ｘ线表现计有：（１）松质骨骨小梁粗疏、细疏或呈网状，肋骨呈“丝瓜筋”状；（２）骨皮质松化；（３）骨转换表现；（４）骨端膨大，关节面模糊伴囊变；（５）肢体弯曲畸形，胫骨弓形弯曲，严重者呈“Ｌ”形，膝内翻或外翻，呈“Ｏ”形或“Ｘ”形腿；（６）椎体“双框征”，附件呈棉絮状改变；（７）髂骨骺下疏松带；（８）耻骨联合、骶髂关节毛刷征；（９）骨盆口三角状变形；（１０）承重肢体出现Ｌｏｏｓｅｒ带及骨间隔；（１１）儿童干骺端喇叭口样膨大，干骺端毛刷征；（１２）囟门闭合延迟，颅缝增宽、模糊。结论：通过对本病Ｘ线表现的认识，有助于提高对ＶＤＲＲ的诊断和鉴别诊断的水平。

Purpose:ToinvestigatetheX-rayfeaturesofvitaminD-resistantrickets(VDRR).Materialsandmethods:8casesofVDRRinonefamilywerereportedandradiographsofthewholeskeletonin7casesweretakenandanalysed.Results:TheX-rayfeatureswere:(1)Coarseorreticu-latedtrabeculaofcancelousbone,especialyinribs;(2)Spongytransformationofcorticalbone;(3)Signsofboneturnover;(4)Enlargementofboneend,articularsurfacehazywithcysticdegen-eration;(5)Limbdeformitybowtibia,‘L’shapedtibiainseverecases,gonyectyposisorgonycrote-siswith‘O’shapedor‘X’shapedlegs;(6)Double-framedvertebralbodyandcotonwoolap-pendagesigns;(7)Rarefiedzonebeneathepiphysisinilium;(8)Brushappearanceofsymphysispu-bisandsacro-iliacjoint;(9)Triangleshapedpelvicoutlet;(10)Looser′szoneandbonyseptuminlowerlimbs;(11)Flaredmetaphysiswithbrushchange;(12)Delayedclosureoffontanel,widenedandhazycranialsutures.Conclusion:RecognitionoftheradiographicfeaturesofVDRRishelpfulinestablishingcorectdiagnosis.