三种肩部X线摄片方法观察肩峰骨赘的比较

Comparision of three radiographic methods in shoulders to observe acromial osteophytes

目的 探讨显露肩峰前缘骨赘及肩关节退变的可靠方法 ,为肩部慢性疾患的诊治提供客观依据。方法 对 183位健康体检的中老年人行肩部前后位 ,向尾侧倾斜 3 0度肩前后位及肩峰前后切线位摄片 ,共 10 98张 ,分三组进行测量 ,将测得结果计算阳性表达率、平均值及t检验。结果 肩峰前后切线位摄片骨赘阳性率右肩 49.14 % ,左肩40 .47% ,向尾侧倾斜 3 0度肩前后位片骨赘出现阳性率右肩 2 5 .68% ,左肩 16.3 9%。肩前后位片双肩骨赘阳性率均在2 %以下。肩峰前后切线位片骨赘均值 ,右肩 0 .3 161cm ,左肩 0 .3 5 0 96cm。向尾侧倾斜 3 0度肩前后位片骨赘均值 ,右肩 0 .0 9788cm ,左肩 0 .0 5 78cm。肩前后位片骨赘均值 :右肩 0 .0 0 90cm ,左肩 0 .0 0 97cm。肩峰前后切线位摄片与向尾侧倾斜 3 0度肩前后位摄片骨赘均值t检验差异显著 (P <0 .0 1)。结论 肩峰前后切线位摄片法较肩前后位摄片法及向尾侧倾斜 3 0度肩前后位摄片法能更准确显现峰前缘骨赘。

Objective To study reliable methods to reveal acromial osteophytes and the degenerate shoulder joints and to provide objective evidence for diagnosing and treating chronic diseases in shoulders. Methods 183 middle and elderly people in physical examinaftion underwent shoulder anterior posterior radiograph with patients erect, shoulder antteror posterior radiograph with a30-degree caudal tilt of the beam, and acromion anterior posterior radiograph with acromion tangented by the beam. There were 1098 pieces of radiographes, and they were divided into three groups to calculate the ostephytes positive rates and average length. Results Among the radiographes made in acromion tangented anterior posterior position, osteophyrte positive rate in right shoulders was 49.14%, in left shoulders 40.47%;and the average osteophyte length in right shoulders was 0.316 1 cm,in left 0.350 96 cm,In the radiographs made with shoulder anterior posterior and the x ray beam tilted 30-degrees caudad, osteophyte positive rates in right shoulders was 25.68%,in left 16.39%;and the average osteophytte length in right was 0.097 88 cm, in left 0.057 8 cm. Radiographes made in shoulder anterior posterior position showed osteophyte positive rates in both shoulders were all below 2%;the average osteophyte length in right 0.009 0,in left was 0.009 7 cm. There was significant difference( P <0.01) in average osteophyte length between radiographs made in acromion tangented anterior poterior position and those made with shoulder anterior posterior with x ray beam tilted 30-degree caudad after tested with t examination. Conclusions Acromuion tangented anterior posterior position can produce radiograph that can better reveal acromion anterior osteophyte than the radiograph made with shoulder anterior posterior with x ray beam tilted 30 degree.