摘要
目的:探讨强直性髋关节炎如何从平片上判断预后功能分期。方法:100例成人AS髋关节炎,男91例,女9例;根据法定成人年龄,本组最小19岁,只有1例71岁,平均29.9岁。临床主要表现为全身乏力,腰背和髋部疼痛,功能障碍。结果:100例成人强直性脊柱炎,其中7例行MR成像检查。均有骶髂关节和髋关节病理性征象和股骨头灶性坏死。关节间隙不同程度狭窄达95%、股骨头关节边缘滑膜骨化发生率达84%。垂线征是一种骨化线,它从股骨头内下缘向外下至股骨颈,发生率为69%。100例成人强直性脊柱炎髋臼窝狭窄的发生率高达75%。耻骨联合边缘硬化或吸收和坐骨结节大收肌腱附着点骨化发生率为53%。根据上述综合征象,提出髋关节炎分为4期。Ⅰ期:两侧髋关节变化轻微;Ⅱ期:髋关节狭窄伴随关节周围有明确异常征象;Ⅲ期:髋关节严重狭窄伴随关节周围的严重异常;Ⅳ期:髋关节韧带骨化融合或骨性融合。结论:以髋关节软骨坏死的程度可将强直性髋关节炎分为4期,体现了预后功能的判断。
Objective To predict the prognosis of hip function in ankylosing spondylitis(AS) from radiograph of the hip arthitis. Methods: In 100 cases of ankylosing spondylitis, MRI was performed in seven cases of them, 91 were male and 9 female. The age ranged from 19 to 71 years with an average of 29.9 years. Chief clinical manifestations were genera[ weakness and pain in low back and hip with disturbed function. Results: Pathologic signs were shown in the sacroiliac and hip joints and focal osteonecrosis in the femoral head. Significant narrowing of joint space was found in 95%. Marginal synovial ossification of femoral head wits found in 84%. Sagging rope sign,an ossification line ranning from medioinferior border of femoral head lateroinferior ly lolateral border of femoral neck.was found in 69%. Narrowing of acetabulnm was found in 75%. Margional sclerosis or absorption of symphysis pubis and ossification in ischial tuberosity at the attachment of adductor major were found in 53%. According to the related signs a grading of 4 grades was suggested its follows, Grade Ⅰ: minimal changes in bilateral hip joints. Grade Ⅱ : narrowed hip joinl with significant periarticular abnormal signs. Grade Ⅲ : severe narrowing of hip joint space with severe periarticular abnormalities. Grade Ⅳ : ossification and coagulation or ossifie coagulation of articular ligment. Conclusion: The grading according to the severity of chondronecrosis into 4 grades was thought practicable for predicting the functional prognosis.
出处
《中国中西医结合影像学杂志》
2008年第5期332-334,共3页
Chinese Imaging Journal of Integrated Traditional and Western Medicine