小儿髋关节结核的影像学表现

Imaging Findings of Hip Joint Tuberculosis of Children

目的探讨小儿髋关节结核的影像学表现。方法回顾性分析24例小儿髋关节结核病例的X线、CT、MRI影像资料。结果病变多累及单侧关节,男孩多见,早期主要表现关节囊和周围软组织肿胀,关节腔积液,病变进展到中后期,主要表现骨质疏松,髋臼及股骨头骨骺破坏,冷脓肿形成并呈流注样扩散,肉芽组织形成,晚期表现为股骨头坏死,关节畸形、脱位及强直等。结论 MRI对于髋关节早期软组织病变,关节积液、脓肿,以及软骨破坏等敏感,X线片对于整体观察骨质疏松、骨质破坏,及关节脱位等有价值,CT能发现细微的骨破坏病灶及死骨等,3种检查方法合理选择,有助于病变早期诊断和长期随访观察。

Objective To study the imaging findings of hip joint tuberculosis of children. Methods Imaging data of X - ray, CT and MRI of 24 cases with hip joint tuberculosis of children were analyzed retrospectively. Results Lesions involeved more than a single, more in boys. Early main manifestations were the swelling of the joint capsule and the soft tissue around and the articular cavity effusion. When disease progressing to later period, the main manife stations were osteoporosis, the destruction of acetabulum and osteoepiphysis of caput femoris, the formation of cold abscess spreading like flow column samples and the formation of granulation tissue. The late manifes- tations were the necrosis of caput femoris, the joint deformities, dislocation and stiffness and so on. Conclusion MRI is a sensitive ex- amination in the early soft tissue lesions, the joint effusion, abscess and the destruction of cartilage. X - ray is an valuable examination in osteoporosis, bone destruction and dislocation of joint. CT can discover the tiny lesions of bone destruction, sequestrum and so on. A rea- sonable choice of these three examinations is in favor of the early diagnosis of lesions and long - term follow - up.