髋关节撞击综合征的诊断和治疗

Femoroacetabular impingement:diagnosis and treatment

目的探讨髋关节撞击综合征(FAI)的临床诊断和治疗的体会。方法通过总结2002年以来29例门诊患者和5例手术患者的临床资料,分析该综合征的临床表现,骨科检查的特点以及放射学检查的特征性改变。结果29例门诊患者中大部分患者起病隐袭,发展缓慢,髋关节的骨科检查可见特征性撞击试验阳性。X线片发现11例股骨头有"枪柄样畸形",20例CE角大于40°,4例髋臼后倾。核磁共振造影检查能够提供准确的盂唇损伤的诊断依据。其中5例患者接受了手术治疗。结论FAI能够引起髋关节疼痛并导致髋骨关节炎,早期发现是治疗的关键。

Objective To investigate the clinical characters and treatment options of femoroaeetabular impingement syndrome. Methods We reviewed clinical data of 29 out-patient clinic eases and 5 operative eases to analyze the symptom eharaeters, physical examination findings and the radiologieal changes. Results The onsets of the symptoms in most eases were insidious with slow progression. Impingement sign was positive for all patients. ＂Pistol＂ like deformities of femoral head could be seen in 11 eases, while 20 eases showed that the CE angle was more than 40 degrees in AP pelvis X-rays. 4 eases had aeetabular retroversion. MRI with arthrography would give clear diagnose of labrum tear. 5 eases received operation treatments. Conclusions Femoroaeetabular impingement syndrome could cause hip pain and osteoarthritis. Recognition of this syndrome would help patients to release their symptoms.