Ⅰ期拇指腕掌关节炎应力位影像学评估的研究及临床意义

The study of stress-positioned radiograph in the assessment of stage Ⅰ thumb carpometacarpal arthritis

目的 研究Ⅰ期拇指腕掌关节炎应力位X线片表现,评估其松弛性及临床意义。方法 分别摄30例正常男性、女性及Ⅰ期拇指腕掌关节炎男性、女性患者的拇指腕掌关节应力位X线片,分别测量第一掌骨基底桡偏宽度(RS)及关节面宽度(AW),计算两者比值,即第一掌骨桡偏比值(R),进行t检验比较正常男性、女性及拇指腕掌关节炎Ⅰ期男性、女性患者的拇指腕掌关节应力位R值,观察差异。结果 正常男性R为0.31±0.12、正常女性为0.37±0.13,Ⅰ期拇指腕掌关节炎男性患者为0.43±0.16、女性患者为0.51±0.15。正常男性与女性相比、正常男性与男性患者相比、正常女性与女性患者相比,差异均有统计学意义,松弛性差异明显(P<0.05)。结论 R可以作为评估Ⅰ期拇指腕掌关节炎的松弛性指标。

Objective To study the X ray manifestations of stress-positioned radiograph of stage Ⅰ thumb carpometacarpal arthritis and evaluate its laxity and clinical significance.Methods The stress-positioned radiograph of30normal men,women and male patients and female patients with stage Ⅰ thumb carpometacarpal arthritis were taken respectively.The radial deviation width(RS)and the joint surface width(AW)of the first metacarpal basal body were measured respectively.The ratio of the first metacarpal radius deviation(R)was calculated,and the t test was used to compare the R value of the normal men,women and male patients and female patients with stage Ⅰ thumb carpometacarpal arthritis.Results The R value was0.31±0.12for normal men,0.37±0.13for normal women, 0.43±0.16for male patients with stage Ⅰ thumb carpometacarpal arthritis and0.51±0.15for female patients.There were obvious differences between normal men and normal women,between normal men and male patients with stage Ⅰ thumb carpometacarpal arthritis,between normal women and female patients.The differences were statistically significant and the laxity was obvious(P<0.05). Conclusion R can be used as an index to evaluate the laxitv of stage Ⅰ thumb camometacarpal arthritis.