超声在老年膝关节软骨滑膜病变检查中的应用

背景：超声作为无创性检查手段应用于骨骼肌系统检查已得到广泛的认识与认可。目的：探讨超声检查在老年人膝关节退行性变中的临床应用价值。方法：选取60岁及以上连续就诊的膝关节疾病患者102例，204个膝关节，根据膝关节退行性变临床诊断标准，分为2组：膝骨关节炎组167个膝关节，非膝骨关节炎组37个膝关节。行膝关节超声探查，观察膝关节髌上囊、内侧滑囊、外侧滑囊积液深度、滑膜、血管翳、软骨情况。结果与结论：204个膝关节中，发生膝关节退行性变的有167膝，原发性膝关节炎91膝，非原发性膝关节炎76膝，退变率82%，膝骨关节炎组膝关节腔髌上囊、内测滑囊、外侧滑囊积液量显著多于非膝骨关节炎组，滑膜增生59膝，伴有血管翳形成23膝，软骨表面毛糙167膝，软骨变薄或丧失117膝。非膝骨关节炎组滑膜增生5膝，软骨表面毛糙27膝，软骨变薄或丧失4膝。结果提示超声作为一种影像学检查手段对评价老年人膝关节退行性变具有实际的应用意义。

Ultrasonography for cartilage synovial disease of the knee in the elderly

BACKGROUND：Ultrasonography as a noninvasive means has been widely recognized in the examination of the skeletal muscle system. OBJECTIVE： To investigate the clinical significance of ultrasonography for the elderly with degenerative knee cartilage. METHODS：Totaly 102 patients （204 knees） who were≥ 60 years old and successively admitted for knee disease were selected and according to clinical diagnostic criteria of degenerative knee disease, divided into two groups： osteoarthritis group （167 knees） and non-osteoarthritis group （37 knees）. Al the knees were subjected to ultrasonography for observing the effusion depth of the suprapatelar bursa, medial bursa and lateral bursa, as wel as the synovium, pannus and cartilage. RESULTS AND CONCLUSION： Of the 204 knee joints, degenerative changes of the knee occurred in 167 knees, primary knee arthritis in 91 knees, secondary knee arthritis in 76 knees, and the degeneration rate was 82%. The volume of effusion in the suprapatelar bursa, medial bursa and lateral bursa was significantly higher in the osteoarthritis group than the non-osteoarthritis group. In the osteoarthritis group, synovial hyperplasia was in 59 knees, pannus formation in 23 knees, rough cartilage surface in 167 knees, and the knee cartilage thinning or loss in 117 knees. In the non-osteoarthritis group, synovial hyperplasia was in 5 knees, rough cartilage surface in 27 knees, and the knee cartilage thinning or loss in 4 knees. These findings indicate that ultrasonography is of certain clinical significance in evaluation of degenerative knee cartilage in the elderly.