X线隧道位对诊断膝关节骨性关节炎的临床价值

Clinical value of tunnel view X-ray in the diagnosis of knee osteoarthritis

目的探讨膝关节X线隧道位对诊断膝关节骨性关节炎的价值。方法对220例膝关节骨性关节炎患者的276个膝关节进行膝关节X线隧道位及常规前后正侧位、髌骨轴位检查,比较2种摄片方法在显示膝关节骨性关节炎X线影像学特征方面的数量差异。结果 2种摄片方法在显示髁间窝骨赘(77.9%vs.40.6%)、胫骨棘骨赘(79.0%vs.64.9%)、股骨内外髁骨质增生(84.1%vs.75.3%)及髁间窝游离体数量(11.6%vs.4.3%)方面比较差异均有统计学意义,X线隧道位可能有优势(P均<0.05);常规前后正侧位、髌骨轴位在显示关节面下囊性变数量、关节腔游离体数量及髌骨上下缘骨质增生方面可能有优势(P均<0.05)。在显示膝关节间隙狭窄时,2种摄片方法可能具一致性(P>0.05)。结论在常规摄片方法的基础上加行X线隧道位可能更有助于辅助诊断膝关节骨性关节炎。

Objective To evaluate the clinical significance of tunnel view X-ray of the knee joint in the diagnosis of knee osteoarthritis. Methods A total of 220 patients with knee osteoarthritis （276 knee joints）received tunnel view X-ray and conventional anteroposterior,anteriolateral and patellar axial radiograph of the knee. Imaging characteristics of knee osteoarthritis were statistically compared between two techniques.Results The quantity of intercondylar fossal osteophyte （77.9% vs.40.6%）, tibial spine osteophyte （79.0% vs. 64.9%）,exterior and interior femoral hyperosteogeny （84.1%vs 75.3%）and loose body of intercondylar fossa （1 1.6%vs. 4.3%）significantly differed between two imaging methods （all P〈0.05 ）,suggesting the evident superiority of tunnel view X-ray. Compared with tunnel view X-ray,conventional anteroposterior,anteriolateral and patellar axial radiograph possessed significant advantages in revealing the quantity of cystic lesion below articular surface,loose body within articular cavity and hyperosteogeny of the upper and lower margins of patella （all P〈0.05 ）.The findings of knee joint stenosis were consistent between two techniques （P〉0.05 ）. Conclusion Based upon conventional radiograph,tunnel view X-ray probably contributes to the adjuvant diagnosis of knee osteoarthritis.