坐骨耻骨骨软骨病的临床影像学诊断(附23例报道)

Clinical imaging diagnosis of ischiopubic osteochondritis: report of 23 cases

目的:探讨坐骨耻骨骨软骨病的临床影像学表现。材料与方法:对23例坐骨耻骨骨软骨病的临床影像学表现和随机抽取100例因其他原因摄骨盆正位片进行分析。结果:病变组23例中,16例为单侧,7例为双侧。X线表现为坐骨耻骨结合处局限性骨膨隆,8例有层状改变,病变区内密度不均,有类圆形低密度透光影,骨皮质完整,8例周围骨质轻度增生,未见骨膜反应和软组织改变。8例CT表现为坐骨耻骨结合处局部膨大,其内有低密度透光区,有碎裂,骨皮质连续性中断,断端边缘欠整齐,邻近的髓腔轻度硬化,无明显的死骨和骨膜反应,邻近的软组织正常;正常组中14例出现上述X线改变,其中3例为双侧性。结论:坐骨耻骨骨软骨病的影像学表现较典型,结合临床表现,即可作出诊断及鉴别诊断。

Objective： To explore the clinical and imaging features of ischiopubica osteochondritis （Van Neck disease）. Methods： Clinical and imaging features of 23 cases with Van Neck disease were reviewed and X-ray films of 100 cases examined for other reasons were randomly chosen. Results： In the 23 cases of disease group, 16 cases were unilateral and 7 cases were bilateral. X-ray examination showed local prominence between ischium and pubis in all cases. Lamellar changes of the bone inhomogeneous in density with round translucence were found in 8 cases accompanied with intact cortex. Mild osseous hyperplasia was found in 8 cases without changes of periosteum and soft tissues. CT examination of 8 cases presented with local prominence between ischium and pubis, translucence, cataclasm, discontiguous osteal cortex with irregular ends, sclerotic medullary cavity of boney surroundings, but no sequestration and changes of periosteum and soft tissues. The abovementioned X-ray features appeared in 14 cases among normal group, bilateral in 3 cases. Conclusion： Imaging features of Van Neck disease were typical, which can help correct diagnosis and differential diagnosis combined with the clinical manifestation.