髋关节暂时性骨质疏松症的诊断与治疗

The diagnosis and treatment of transient osteoporosis of the hip

目的探讨髋关节暂时性骨质疏松症(transient osteoporosis of the hip)的诊断和治疗问题。方法收集2003年1月至2010年1月患髋关节暂时性骨质疏松症的患者11例,通过病史、体格检查、X线片及MRI等影像资料明确诊断,采用髋部制动、休息、药物等措施治疗。入院及末次随访时采用疼痛视觉模拟评分(VAS)评估疼痛程度,采用Harris髋关节评分评价髋关节功能改善情况。结果11例患者均获得痊愈,恢复期从3到8个月不等,平均6个月;Harris评分从入院的67.3±5.4到末次随访时的91.2±4.8,VAS评分从入院时的(7.25±1.51)降到末次随访时的(1±0.62)分。痊愈的标准有症状完全消失,MRI完全恢复正常。结论髋关节暂时性骨质疏松症是一种自限性疾病,采用保守治疗的方法,均可以痊愈。MRI是确定诊断的主要方法;应注意和股骨头缺血性坏死等髋关节疾病相鉴别。

Objective To investigate the diagnosis and treatment of transient osteoporosis of the hip. Methods Eleven patients with transient osteoporosis of the hip from January 2003 to January 2010 were selected. All the patients were diagnosed by history, physical examination, X-ray and MRI, and they received treatments including hip fixation, rest and medicine treatment. Visual analog scores （VAS） were tested at the time of admission and the last follow-up. The improvement of hip function was tested using Harris hip score. Results All of the 11 patients got cured with a recovery time from 3 to 8 months, and the mean time was 6 month. The value of Harris hip score changed from 67.3 ±5.4 at admission to 91.2 ±4.8 at the last follow-up. The value of VAS decreased from 7.25 ±1.5 at admission to 1 ±0. 62 at the last follow-up. The standard of recovery was the disappearance of all symptoms and MRI image became normal. Conclusion Transient osteoporosis of the hip is a self-limited disease and it can be cured by employing conservative therapy. MRI is the main method to confirm diagnosis. This disease should be differentiated with other hip joint diseases including avascular necrosis of the femur head.