成人大骨节病与骨关节炎患者髋关节影像学表现的对比研究

A Comparative Study on Hip X - ray Feature of Adult Kashin - Beck Disease and Primary Hip Osteoarthritis

目的：研究成人大骨节病髋关节病变的影像学特点，并与骨关节炎患者进行对比。方法：对四川省壤塘县112例（224髋）确诊为成人大骨节病的患者进行髋关节摄片，观察髋关节髋臼侧、股骨侧有无影像学改变，测量髋关节Sharp角、CE角、髋臼指数、头转子间距离、头颈指数和颈干角，并将测量结果与我院40例（80髋）原发性骨关节炎患者进行对比分析。结果：224髋中有22髋（9．8％）出现髋部异常改变，主要表现为髋臼软骨下骨硬化或囊变、股骨头形态不规则伴密度异常、颈干角变小。112例患者Sharp角平均37．92°、CE角平均30．26°、髋臼指数平均43．86、头转子间距离平均1．69cm、头颈指数平均1．80、颈干角平均121．8°。与骨关节炎患者相比，大骨节病组患者颈干角较小，其组间差异有统计学意义（P〈0．05），但均在正常范围内；其余测量指标两组比较均无统计学差异。结论：成人大骨节病部分患者髋关节在影像学方面具有异常改变，主要表现为髋臼软骨下骨硬化或囊变、股骨头形态不规则伴密度异常、颈干角变小。上述影像学改变与骨关节炎患者相比无明显特异性。

Objective： To study the hip X - ray feature of adult Kashin - Beck disease （KBD） patient compared with primary hip osteoarthritis in Rangtang country, Siehuan province. Methods：112 adult KBD patients （224 hips） in Rangtang country were ex- amined with X - ray on their hip. Acetabulum, femoral head and neck were analyzed in X - ray to make sure whether KBD patients＇ hip were abnormal. Based on above analysis, Sharp angle, CE angle, acetabular index, distance between femoral head and greater tro- chanter, head - neck index, neck - shaft angle were measured in X - ray compared with 40 primary hip osteoarthritis （ 80 hips ） pa- tients in our hospital. Results ：22 hips （9.8%） showed hip X - ray abnormal, in which the aeetabular subchondral bone sclerosis or cystic degeneration, femoral head irregular with abnormal density and neck - shaft angle decrease were the most typical changes. For 112 KBD patients, the average Sharp angle was 37.92°, CE angle was 30.26°, acetabular index was 43.86°, distance between femo- ral head and greater troehanter was 1.69, head - neck index was 1.8 and neck - shaft angle was 121.8°. Compared with 40 primary hip osteoarthritis patients, significant difference was found at neck - shaft angle, although neck - shaft angle in both groups were nor- mal. Conclusions ： Hip X - ray of adult KBD disease shows abnormal changes, acetabular subehondral bone sclerosis or cystic degener- ation, femoral head irregular with abnormal density and neck - shaft angle decrease are the most typical changes. Compared with pri- mary hip osteoartbritis, the X -ray abnormalities above in KBD show no significant specificity.