髋关节快速破坏性骨关节病五例报告

Rapidly destructive hip osteoarthritis:5 cases report

目的回顾5例(7髋)髋关节快速性破坏性骨关节病患者的临床转归过程,探讨Bekki-RDO分型的改进。分析患者实验室及辅助检查,发现患者病程发展特点,并对疾病的诊断、治疗进行初步探讨。方法 2004至2012年,我院收治5例(7髋)髋关节快速破坏性骨关节病患者,回顾其临床表现及转归。结果 5例(7髋)早期临床表现为定位不清的患肢疼痛功能障碍,后期疼痛定位于患肢腹股沟中段。实验室检查除碱性磷酸酶、血沉、转氨酶轻度升高,其余化验结果无特异性改变。影像学上患肢髋关节半年内呈现快速的进行性破坏表现,根据影像学改变特点,可归纳分型为:I型:间隙缩窄型、II型:骨组织萎缩型、III型:骨组织崩解碎裂型、IV型:骨组织吸收型。以上患者经手术治疗后,取得良好疗效。结论本组5例髋关节快速性破坏性骨关节病患者临床表现较为典型,改进的RDO分型能够为临床诊断与治疗提供有效的帮助。

Objective To review the clinical outcome process of 5 patients （ 7 hips ） with rapidly destructive hip osteoarthritis, to investigate the improvement of Bekki-rapidly destructive osteoarthritis （ RDO ） typing, to analyze the laboratory tests and auxiliary examinations, to explore the course characteristics of the patients and to preliminarily discuss the diagnosis and treatment of this disease.Methods The clinical presentations and outcomes of 5 patients （ 7 hips ） with rapidly destructive hip osteoarthritis who were adopted from 2004 to 2012 were reviewed.Results The clinical manifestations of the 5 patients （ 7 hips ） included ill-positioned pain and dysfunction in the affected limbs in the early period, and later pain in the middle part of the groin was noticed. The laboratory tests revealed that the alkaline phosphatase, erythrocyte sedimentation rate, transaminase were mildly elevated, and no speciifc changes were found in the rest test results. Within half a year, the radiography showed fast and progressive destruction in the affected limbs and hips. According to the image changes, there were 4 types in all, including type Ⅰ of narrowing the gap, type Ⅱ of bone tissue atrophy, type III of bone tissue disintegration and fragmentation and type Ⅳ of bone tissue absorption. Good results were achieved in the patients when they underwent the surgery.Conclusions The clinical manifestations of the 5 patients with rapidly destructive hip osteoarthritis are representative, and the modified RDO typing could provide effective help for the clinical diagnosis and treatment.