成人髋臼发育不良性骨关节病的影像学表现

Imaging diagnosis of acetabular dysplastic coxarthrosis in adult

目的 探讨成人髋臼发育不良性骨关节病的影像学表现。方法 对 5 1例 87个髋成人髋臼发育不良的影像资料进行回顾性分析。患者除男性 4例外均为女性 ,年龄 2 2～ 78岁 ,平均42 6岁。所有患者均摄有标准的骨盆前后位X线片 ,18例行CT扫描 ,10例行MR扫描。结果 87个发育不良髋臼的主要X线改变为髋臼浅小 ,倾斜度增加和对股骨头覆盖不全。测量中心边缘角 (CE)为 - 10°～ 3 0°,平均 12 9°。测量髋臼指数为 3 5°～ 67° ,平均 45 3°。其中 75髋 (84 2 % )有继发性骨关节炎 ,5 4髋 (62 1% )出现髋臼或股骨头负重区软骨下囊性变 19髋 ,伴有髋关节半脱位。CT和MRI发现平片不能显示的小囊变和股骨头向前移位者分别为 13髋和 10髋。结论 髋臼或股骨头囊样病变是髋臼发育不良性骨关节病的常见表现 。

Objective To investigate the imaging diagnosis of acetabular dysplastic coxarthrosis. Method The imaging of the acetabular dysplasia was analyzed in 51 patients (87 hips). All but four patients were women. The age ranged from 22 to 78 years, and the mean age was 42.6 years. Pelvis radiographs were studied in all cases, and CT scan was performed in 18 cases and MRI in 10 cases. Results The fundamental signs on the plain film included shallow acetabulum, increased obliquity and insufficient coverage of the femoral head by the acetabulum. The CE angles were determined in all the cases, ranging from -10° to 30°, mean 12.9°. The charp angles ranged from 35° to 67°, mean 45.3°. The secondary osteoarthritis were revealed in 75 hips (84.2%). 54 hips (62.1%) had cyst like lesions in weight bear area of the acetabulum or femoral head. 19 hips had subluxation of femoral head. CT and MRI displayed small cystlike lesions and forward shift of the femoral head, which could not be shown on plain film, respectivly in 13 and 10 hips. Conclusion The cyst like lesion of subarticular region is a common sign in acetabular dysplastic coxarthrosis. CT or MRI can show the early osteolytic lesion and forward subluxations.