儿童髋关节暂时性滑膜炎合并滑膜疝的彩色多普勒超声诊断价值

The diagnostic value of color doppler ultrasound in transient synovitis of hip combined with synovial hernia in children

目的探讨儿童髋关节暂时性滑膜炎合并滑膜疝的彩色超声诊断价值。方法应用彩色超声诊断仪,频率9-4MHz、13-7MHz线阵探头,取平卧位、沿股骨颈长轴纵切和横切,二维观察髋关节前隐窝滑膜厚度、积液深度、疝囊的大小、位置、疝口直径,CDFI观察滑膜及疝囊周围软组织血供情况。结果检出髋关节暂时性滑膜炎合并滑膜疝21例,男16例,女5例;左侧17例,右侧4例;疝囊平均直径（5.17±1.54）mm,疝口平均直径（2.38±0.65）mm;血供0级11例、1级5例、2级3例、3级2例;其超声特征为患侧髋关节前隐窝滑膜不规则增厚,液性回声〉2mm且积液经前关节囊呈囊状向前突出。结论儿童髋关节暂时性滑膜炎合并滑膜疝具有典型超声声像图表现,超声具有检出率高、费用低、无辐射、假阴性率低、可重复等优势,在该病诊断、鉴别诊断及疗效评价方面具有重要意义。

Objective To explore the methods of diagnostic value of transient synovitis of hip（TSH）combined with synovial hernia in children by color ultrasound.Methods Color ultrasound diagnostic apparatus with a frequency of 9-4 MHZ,13-7 MHZ linear probe were used in the examinations.Patients were firstly supine,and then some indicators were observed along the long axis of the femoral neck longitudinal and transverse in two-dimensional included the thickness of hip fossae synovial membrane,the depth of the fluid,the size of position of hernial sac,the diameter of hernia orifice.The blood supply of synovial membrane and the hernial sac surrounding soft tissue was observed by CDFI.Results Totally 21 cases suffered from transient synovitis of hip with synovial hernia were detected.Among them,16 cases were male,5 cases female.The affected parts of 17 cases were on the left side,and other 4 cases were on the right side.Average diameters of the sac were 5.17±1.54mm.The average diameters of the hernia orifice were 2.38±0.65mm. The level of blood supply was 0in11 cases;1level in5 cases;2level in3 cases;and3level in2 cases.Ultrasound features：ipsilateral synovial anterior recess of hip joints was irregular thicken,and echo of liquid 2mm and effusion were protruded via the anterior joint capsule.Conclusions There are typical sonographic manifestations in transient synovitis of hip with synovial hernia in children.Ultrasonography has advantages of high detection rate,low cost,no radiation,low false negative rate,and with a good repeatability in both diagnosis and treatment.Therefore,high-frequency ultrasound plays an important role in diagnose of disease,differential diagnosis and treatment evaluation of TSH combined with synovial hernia in children.