膝骨关节炎X线表现与膝关节疼痛程度的相关性分析

A correlation analysis of the relationship between X-ray manifestation and knee pain degree in knee osteoarthritis

目的:分析膝骨关节炎X线表现与膝关节疼痛程度的相关性。方法:为103例膝骨关节炎患者拍摄正位和侧位膝关节数字透视摄影片,测定膝关节内侧间距、外侧间距、内外侧间距比值,并对膝关节骨赘进行评分。同时采用视觉模拟评分法评定膝关节疼痛程度。对膝关节X线表现与膝关节疼痛评分进行相关性分析。结果:本组患者膝关节疼痛评分为(7.49±1.23)分;膝关节内侧间距(38.02±9.53)mm,外侧间距(48.01±10.59)mm,内外侧间距比值(1.33±0.37)%;膝关节骨赘评分,外侧区(0.33±0.47)分,中间区(0.81±0.40)分,内侧区(0.34±0.48)分,髌股区(0.75±0.44)分,总分(2.22±1.21)分;无骨赘者9例,1个部位出现骨赘者20例,2个部位出现骨赘者32例,3个部位出现骨赘者23例,4个部位出现骨赘者19例。相关性分析结果显示,膝关节中间区骨赘评分和髌股区骨赘评分与膝关节疼痛评分呈正相关(r=0.203,P=0.014;r=0.177,P=0.032)。结论:膝骨关节炎患者的膝关节中间区和髌股区骨赘是影响膝关节疼痛程度的主要解剖因素。

Objective：To analyse the correlation between X-ray manifestation and knee pain degree in knee osteoarthritis （KOA）. Methods：The frontal and lateral digital radiograph of knee joints of 103 patients with KOA were used to assess such parameters as the me- dial joint space width,lateral joint space width and the ratio of medial joint space width to lateral joint space width, and the knee joint osteo- phytes were measured and scored. Meanwhile,the degree of knee joint pain were measured by using a visual analogue scale. Then,the rela- tionship between X-ray manifestation and knee joint pain score were analysed by correlation analysis. Results：The knee joint pain scores of the patients were（ 7.49 ± 1.23 ）. The medial joint space width, lateral joint space width and the ratio of medial joint space width to lateral joint space width were （ 38.02 ± 9.53 ） ram, （48.01 ± 10.59 ） ram, （ 1.33 ± 0.37 ） %, respectively. The scores of knee joint osteophytes in the lateral zone,intermediate zone, medial zone, patellofemoral zone and the total scores were （0.33 ± 0.47 ）, （ 0.81 ± 0.40 ）, （ 0.34 ± 0.48）, （0.75 ± 0.44）, （2.22 ± 1.21 ） respectively. No osteophytes were found in 9 subjects, while osteophytes were found in one location of the knee in 20 subjects,two locations in 32 subjects,three locations in 23 subjects and four locations in 90 subjects. The results of corre- lation analysis showed that the scores of knee joint osteophytes in intermediate zone and patellofemoral zone were positively correlated with the scores of knee joint pain（ r = 0. 203, P = 0. 014 ; r = 0. 177, P = 0. 032 ）. Conclusion ： Osteophytes in the intermediate zone and patel- lofemoral zone of knee joint are the main anatomy factors influencing knee pain degree in patients with KOA.