骶髂关节结核X线表现与鉴别诊断(附31例分析)

Radiological Manifestations and Differentiation of Tuberculosis of Sacroiliac Joint: An Analysis of 31 Cases

目的 探讨骶髂关节结核的X线表现及与其他病变的鉴别诊断。资料与方法 搜集 31例经手术、病理证实的骶髂关节结核 ,并对其X线表现及鉴别进行了分析。结果 右侧 17例 (5 5 % ) ,左侧 12例 (39% ) ,双侧 2例(6 % )。典型X线表现 :(1)骨型骶髂关节结核呈圆形或椭圆形破坏区 ,并累及髂骨侧关节面。 (2 )滑膜型骶髂关节结核呈 :①关节面模糊、糜烂 ,骨质破坏 ,关节间隙狭窄或不规则增宽 ;②大块死骨或散在颗粒状高密度影 ;③骨质增生硬化。结论 骶髂关节结核的X线表现有一定的特征性 。

Objective To investigate X-ray manifestations of tuberculosis of sacroiliac joint and to discuss the differentiation with other diseases.Materials and Methods The X-ray findings in 31 cases with pathologically-proved tuberculosis of sacroiliac joint were retrospectively analyzed. The differentiation with other diseases was discussed.Results The lesions involved right sacroiliac joint in 17 cases (55%), left sacroiliac joint in 12 cases (39%) and both sides in 2 cases (6%). The typical X-ray signs were as follows: (1) bony type: the lesion presented as round or ellipse destruction, and the iliac articular surface was involved. (2) synovial type: the lesion presented the following three signs: ① indistinct and erosive joint surface, bony destruction, narrowed or irregular joint space; ② large sequestrum, or scattered grain-like high density shadows; ③ hyperostosis and osteosclerosis.Conclusion The tuberculosis of sacroiliac joint carries certain characteristic X-ray sings, therefore, the conventional plain X-ray films can yet be regarded as the first choice.