臀肌挛缩症患者髌股关节影像学相关指标研究

Study on the Radiographic Parameters of Patellofemoral Joint in the Patients of Gluteal Muscle Contracture

目的:通过对臀肌挛缩患者和正常人髌骨轴位片各影像学指标的对比,探讨臀肌挛缩对青少年、中青年髌骨不稳定和髌股关节发病的影响。方法:2011年4月-2013年1月,臀肌挛缩症患者男性14例26膝,女性22例40膝,均拍摄屈膝30°髌骨轴位片,记录各影像学指标测量结果,并进行统计学分析。结果:1)在屈膝30°髌骨轴位片上,患者男组和正常男组、患者女组和正常女组除股骨滑车沟角无明显差异外(P>0.05),其余各影像学指标比较差异均有统计学意义(P<0.05);2)在髌骨分型(Wiberg分型)上,患者男组和正常男组、患者女组和正常女组比较差异均有统计学意义(P<0.05)。3)在髌骨不稳定的其他旁证上,髌骨外侧关节面软骨下骨质密度增高,髌骨外缘骨赘形成,髌骨外缘骑跨股骨外髁,患者组和正常组比较,差异有统计学意义(P<0.05)。结论:1)臀肌挛缩患者的髌骨不稳定;2)臀肌挛缩患者与正常人相比,较早的出现了髌股关节的退变和髌股关节骨性关节炎;3)臀肌挛缩患者并未见其股骨髁发育不良。

Objective：To compare the radiographic parameters on the patella axial slices between the gluteal muscle contracture（GMC）patients and normal volunteers,and discuss the effect of GMC on patellar instability and patellofemoral joint diseases in adolescents,young and middle-aged patients.Methods：All 14 male patients（26knees）and 22 female patients（40knees）of GMC were observed from April 2011 to January 2013.All patients had received the X-ray examination when the knees 30°flexed.The radiographic parameters were retrospectively analyzed.Results：1）All the radiographic parameters except FSA had statistically differences between the GMC patients and normal volunteers（P〈0.05）.2）There were statistically differences on the patella typing（Wiberg typing）between the GMC patients and normal volunteers（P〈0.05）.3）There were statistically differences between the groups on the other circumstantial evidences of patellar instability,such as bone density increased in the patellar articular surface（P〈0.05）,the osteophyte formation on patellar outer edge（P〈0.05）,and patella outer edge straddling the femoral lateral condyle（P〈0.05）.Conclusion：1）The GMC patients could suffer with patellar instability.2）The degeneration of the patellofemoral joint and the symptom of patellofemoral osteoarthritis could come out earlier in the GMC patients than the normal volunteers.3）There is no femoral condylar hypoplasia in the GMC patients.