膝关节退行性骨关节病的MRI表现

目的 :探讨MRI对膝关节退行性骨关节病的诊断价值。方法 :对手术、关节镜或临床证实的 2 1例 2 6个膝关节退行性骨关节病的MRI表现进行回顾性分析。结果 :MRI能较好地显示膝关节病变的关节软骨、半月板、韧带、骨质等改变 ,还能对关节软骨、半月板损伤和退变进行分级 ,明显优于传统X线检查。结论 :MRI检查能清楚显示退行性骨关节病的病变特点和严重程度 ,为临床选择合适的治疗方案提供了依据。     

低场MRI在膝关节退行性骨关节病中的诊断价值

目的探讨低场MRI对膝关节退行性骨关节的诊断价值。方法对经手术、关节镜或临床证实的60例(65个)膝关节退行性骨关节病的低场MRI表现进行回顾性分析。结果低场MRI能较好地显示膝关节关节软骨、半月板、骨质及韧带等变性、损伤,较传统X线检查有明显优势。结论低场MRI对膝关节退行性骨关节病的诊断有重要价值。     

MR扩散加权成像诊断膝关节骨关节病髌骨软骨病变的价值

目的探讨 MR 扩散加权成像(DWI)在膝关节软骨早期病变诊断中的临床应用价值。方法 18例正常健康志愿者36个膝关节、10例骨关节炎(OA)患者18个膝关节行常规序列及 DWI序列扫描。测量髌软骨各个感兴趣区的表观扩散系数(ADC)值,比较各组间的差异。结果正常健康志愿者组36个髌软骨 ADC 均值(ADCav)为(7.8±2.3)×10~(-4)mm~2/s,髌软骨上、中、下部的 ADC值分别为(7.9±2.3)×10~(-4)mm~2/s、(7.7±2.7)×10~(-4)mm~2/s、(7.9±2.5)×10~(-4)mm~2/s,之间差异无统计学意义(F=0.050,P=0.951)。OA 患者髌软骨 ADCav 为(10.5±4.1)×10~(-4)mm~2/s,髌软骨上、中、下部的 ADC 值分别为(10.8±4.1)×10~(-4)mm~2/s、(10.4±4.4)×10~(-4)mm~2/s、(10.5±4.2)×10~(-4)mm~2/s,之间差异无统计学意义(F=0.940,P=0.910)。但 OA 组的 ADC 值明显高于正常组,两组间差异有统计学意义(t=-2.577,P=0.017),其中以髌软骨内侧份 ADC 值改变最为显著。结论MR DWI 能发现常规 MR 软骨信号尚未改变的更早期软骨病变。     

肥大性骨关节病临床X线分析(附7例分析)

肥大性骨关节病 (hypertrophicosteoarthropathy ,HOA)病因不明 ,临床上较为少见 ,分为原发性和继发性两种。笔者现将资料完整的 7例病人结合文献讨论如下。1　材料与方法　　 7例病人 ,男 6例 ,女 1例 ,年龄 2 1～ 6 8岁 ,平均年龄 39岁。其中 2例为原发性 ;5例继发于肺部病变     

右膝关节退行性骨关节病特殊表现1例

1　病历简介患者 ,5 5岁。因膝关节疼痛半年近期加重就诊 ,以膝关节骨关节病收入院。Ｘ线检查 :膝关节间隙变窄 ,诸骨边缘不同程度棘样增生 ,关节面轻度硬化 ,股骨内髁见小透亮影 ,同侧关节间隙内见长约 2 .0ｃｍ边缘规则长条状透亮影 ,与关节间隙平行 (附图 ,箭头所示 )。诊断 ,右膝关节退行性骨关节病 (真空关节形成 )。2　讨论关节内气体 ,又称暂时性自然关节气造影 ,儿童多见。此病症是由于突然肌肉牵拉、外力牵引 ,使关节内压突然降低和容积突然增加 ,关节周围组织内的气体进入关节所致。成人多见于椎间盘 ,由于椎间盘长期磨损 ,形成真…     

DDR对膝关节退行性骨关节病的诊断价值

膝关节退行性骨关节病是一种老年病、多发病，患者多表现为膝、关节疼痛，活动受限，行走不便。给患者带来生活不便。 笔者对有临床症状需摄片检查的患者，均给予DDR摄影后，对图像作后处理后并作出诊断，对所见X线征象进行了分析。     

腰椎小关节病的临床与CT研究

本文报告了５０例腰椎小关节病的ＣＴ和临床表现，ＣＴ扫描的表现为：关节面不对称；腰椎小关节突增生、肥大；关节突骨赘形成；关节软骨下骨硬化、糜烂、关节间隙狭窄；关节真空现象、关节周围及关节囊钙化。讨论了腰椎小关节病的发病机理和它的临床意义及治疗问题，并指出ＣＴ对腰惟小关节病的诊断明显优于传统ｘ线检查。     

Diagnostic performance of diffusion-weighted MR imaging in differentiation of diabetic osteoarthropathy and osteomyelitis in diabetic foot

PurposeTo study the diagnostic performance of diffusion weighted MR imaging in differentiation of diabetic osteoarthropathy and osteomyelitis in diabetic foot.Patients and methodsThis prospective study was carried out on 41 patients with diabetic foot, 22 males and 19 females with mean age of 51 years. They underwent diffusion-weighted MR imaging of the foot. The apparent diffusion coefficient (ADC) values of the bony lesions were calculated by two reviewers and correlated with the surgical findings or biopsy. The kappa statistic (k) was used to estimate the proportion of inter-observer agreement of two reviewers.ResultsThe mean ADC of acute diabetic osteoarthropathy was 1.27 ± 0.19 × 10⁻³ mm²/s for reviewer 1 and 1.26 ± 0.21 × 10⁻³ mm²/s for reviewer 2. The mean ADC value in diabetic osteomyelitis was 0.86 ± 0.11 × 10⁻³ mm²/s for reviewer 1 and 0.85 ± 0.12 × 10⁻³ mm²/s for reviewer 2. There was excellent inter-observer agreement of ADC value of bony lesions in diabetic foot by both reviewers (K = 0.93). There was statistically significant difference in the ADC values of both groups (P = 0.001). The cut-off point of ADC value of both reviewers used in differentiating acute diabetic osteoarthropathy and osteomyelitis were 0.98 × 10⁻³ mm²/s and 1.04 × 10⁻³ mm²/s with an accuracy of 94% and 93% and area under the curve of 0.94 and 0.93 respectively.ConclusionWe conclude that the ADC value is a non-invasive imaging parameter that can help in differentiation of diabetic osteoarthropathy from osteomyelitis with excellent inter-observer agreement.     

大骨节病的X线及CT诊断

目的 提高对大骨节病的影像学表现认识。方法 16例大骨节病患，男10例，女6例，均行X线检查，在发现病变后加照手、腕、膝、踝关节平片。12例又经膝、踝关节CT螺旋扫描。14例行实验室检查。结果 病变呈对称性、多发性，以手、踝关节多见。X线表现为骺板软骨多发锯齿状凹陷，凹陷底部示不同程度硬化。骨性关节面变薄、中断。骨端凹陷，硬化、粗大，并见刺状骨质增生，关节旁软组织内存在多个不规则形游离小体。跟骨变短、距骨变扁。在距关节面10mm以上的骨松质及皮质均未见异常改变。实验室检查示血清碱性磷酸酶升高。结论 大骨节病凭X线检查多可明确诊断CT扫描在显示骨性关节面及关节周围改变较X线有明显优越性。     

肺性肥大性骨关节病的骨显像研究

目的 观察各种肺疾病肺性肥大性骨关节病（HPO）的发生率、治疗后HPO的消失率以及骨显像与X线诊断HPO的价值。方法 对703例各种肺疾患患者的骨显像作回顾性分析。显像剂为^99Tc^m-亚甲基二磷酸盐（MDP）。结果 （1）703例各种肺疾患患者HPO的发生率为7．4％,其中肺癌患者HPO发生率为7．6％。（2）41例肺癌经手术或化疗后HPO消失31例。（3）32例甲状腺癌和骨癌肺转移患者骨显像无1例发生HPO,但4例鼻咽癌肺转移患者3例为HPO。结论 （1）骨显像出现HPO图像可提示肺疾患的发生;（2）鼻咽癌肺转移HPO发生率较高,临床上鼻咽癌患者骨显像出现HPO表现可提示发生肺转移。     

CT-guided aspiration biopsy of infected aortic graft in a patient with hypertrophic osteoarthropathy. Saline injection to improve diagnostic yield--a case report

Unilateral hypertrophic osteoarthropathy can be a diagnostic clue to chronic infection of an aortic graft and aorto-enteric fistula. In a 62-year-old woman, non-invasive diagnostic procedures failed to prove the infection. CT-guided fine needle biopsy revealed the pathogens prompting re-intervention. The biopsy result was markedly improved by injecting physiologic saline into the perigraft tissue.     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.