膝关节骨性关节炎的X线测量与分析

X-ray analysis and measurements in patients with osteoarthritis of the knee.

目的:通过对膝关节骨性关节炎患者X线片的测量,分析膝关节骨性关节炎患者股骨、胫骨和髌骨形态学改变,以及三者之间排列关系的改变,进而分析这些改变在膝关节骨性关节炎中的诊治意义和作用。方法:取正常组100例膝和膝关节骨性关节炎组127例膝,拍摄正位、侧位和髌骨轴位CR片,并对其分组逐一测量股骨角等指标,应用统计学方法对测量结果卡方检验,对检验结果进行分析,并结合临床进行讨论。结果:膝关节骨性关节炎组(KOA组)胫骨角等的检验结果与正常组存在差异,有统计学意义。而股骨角的检验结果与正常组间无差异。结论:①在膝关节骨性关节炎患者影像学分析中,出现了胫骨角等指标的变化。股骨角对于膝关节骨性关节炎的影像学分析不敏感。②在膝关节骨性关节炎患者影像学分析和统计学检验中,验证了膝内翻发生率高于膝外翻,股胫关节内侧间隙狭窄多于股胫关节外侧间隙狭窄。③在膝关节骨性关节炎患者X线分析中,发现髌股关节可出现髌骨外翻脱位。

Objective： To find morphologic changes of femur, tibia and patella, and the relationship betweeon the changes by measuring and analysing X-ray signs of the knee osteoarthritis （KOA）, then avalutaing the significance and effects of these changes in diagnosis and therapy. Methods： According to American College of Rheumatology （ACR） clinical diagnosing criteria for osteoarthritis of the knee, 100 knees in normal group and 127 knees in KOA group were collected. The anteroposterior, lateral position for knee and axial position for patella using CR, and the femoral angle were measured. Statistical method X2 check for results was used . The results were drawn and discussed combined with clinic. Results： Proof-test results for tibial angle showed the differences between normal group and KOA group,and resuits for femoral angle show there was no difference between the groups. Conclusion： 1. Changes of the tibial angle is significant for diagnosis of KOA; 2. The femoral angle,is no significant in assessing photographs of KOA; 3. These results proved that the incidence rate of the genu varum is higher than the genu valgum and tibiofemoral joint space narrowing on medial more than on lateral; 4. In the KOA photographs, it is often found that the femoralpatella joint can form eversion dislocation .