正常肘部脂肪垫X线表现及其临床意义

The X-ray Performance of Normal Fat Pad of Elbow and its Clinical Significance

目的:提高对正常肘关节脂肪垫X线表现的认识。方法:分析182例正常肘关节脂肪垫的X线表现。在标准肘关节侧位X线片上观察脂肪垫出现频率及其位置、形态和密度,并测量其最大厚度值。按年龄分为"<18岁组(未成年)"和"≥18岁组(成人)",按性别分为"男性组"和"女性组",对各组数据进行统计学分析。结果:符合研究条件的共182例,成人132例,未成年人50例。所有病例均可见肘前脂肪垫(100%),而肘后脂肪垫均未显示。正常肘关节侧位X线片显示AFP紧贴肱骨远端并向前方突出,呈锐角三角形,锐角尖端指向近端,其前外缘平直,密度低于周围肌肉及骨骼。未成年人及成年人AFP厚度值分别为(3.42±0.71)mm、(3.13±0.70)mm,二者存在差异性(t=2.468,P=0.015<0.05);男性组和女性组AFP厚度分别为(3.21±0.70)mm、(3.22±0.73)mm,二者无差异性(t=-0.085,P=0.932>0.05)。成人AFP 95%的参考值范围(双侧)上下限值分别为4.50 mm、1.76 mm;未成年人上下限值分别为4.81 mm、2.03 mm。结论:正常肘关节X线侧位片上PFP不能显示,但均可见AFP,未成年人和成人AFP正常厚度值存在差异性,男女之间无差异。正确认识肘关节脂肪垫的X线表现,有助于评估肘关节外伤患者的病情。

Objective： To raise awareness on the X-ray performance of normal elbow fat pad. Methods： Analyzed 182 cases of X-ray performance on normal elbow fat pad. Observed the frequency of the fat pad occurrence, position, shape, and density on the standard lateral X-ray, and measured the maximum thickness. All the subjects were divided into two groups by age, 〈 18 years （juveniles） and ≥ 18 years （adult）, and then male and female groups according to gender. All the data were collected for statistical analysis. Results： 182 cases were eligible for the study, including 132 adults and 50 juveniles. The anterior fat pads （AFP） were visible and the posterior fat pad （PFP） were invisible in all cases. In the normal lateral X-ray of elbow, the anterior fat pad was close to the distal end of the humerus and extrude to the front with a sharp triangle change angle of which points to the proximal end. The outer edge of AFP was straight,while the density was lower than the muscles and bones, surrounded The thickness value of AFP of juvenile s and adults were difference （t = 2.468, P = 0.015 〈 0.05）; The thickness （3.42±0.71）mm and （3.13 ±0.70）mm with a obvious value of AFP of the male and female groups were （3.21 ±0.70） mm and （3.22± 0.73） mm with no difference （t = 0.085, P = 0.932 〉 0.05）. The up and down limit of 95% reference range of AFP of adult were 4.50 mm and 1.76 mm. And the up and down limit of 95% reference range of AFP of juvenile were 4.81 mm and 2.03 mm. Conclusions： The anterior fat pad （AFP） was visible while the posterior was invisible. There was an obvious difference of thickness value of AFP between the juveniles and adults, but no difference between men and women. Correctly identifying of the X-ray of the performance of fat pad can greatly help to evaluate the condition of the elbow trauma patients.