Imaging of the hip in patients with rheumatic disorders

Hip joint abnormalities are commonly encountered in patients with rheumatic disorders. Although conventional radiography remains the mainstay for diagnosis of joint damage and subsequent follow-up, magnetic resonance imaging and, to a lesser extent, ultrasound have afforded the ability to detect early signs of articular involvement (i.e., synovitis and bone erosions), and to assess disease activity in treated patients. In more advanced stages of rheumatic disorders, magnetic resonance imaging and ultrasound are both useful in assessing paraarticular involvement (i.e., bursitis and synovial cysts).     

Greater trochanter pain syndrome: A descriptive MR imaging study

Objective

Greater trochanter pain syndrome (GTPS) is a diverse clinical entity caused by a variety of underlying conditions. We sought to explore the impact of (1) hip morphology, namely the center-edge angle (CEa) and femoral neck-shaft (NSa) angle, (2) hip abductor tendon degeneration, (3) the dimensions of peritrochanteric edema and (4) bursitis, on the presence of GTPS, using MR imaging.

Materials and methods

The presence of pain was prospectively assessed blindly by the senior author. CEa and NSa were blindly measured in 174 hip MR examinations, after completion of the clinical evaluation by another evaluator. The existence and dimensions of T2 hyperintensity of the peritrochanteric soft tissues, the existence and dimensions of bursae, as well as degeneration and tearing of gluteus tendons were also recorded.

Results

Out of 174 examinations, 91 displayed peritrochanteric edema (group A) and 34 bursitis, all with peritrochanteric edema (group B). A number of 78 patients from both A and B groups, showed gluteus medius tendon degeneration and one tendon tear. CEa of groups A and B were 6° higher than those of normals (group C, P = 0.0038). The mean age of normals was 16.6 years less than in group A and 19.8 years less than in group B (P < 0.0001). Bursitis was associated with pain with a negative predictive value of 97% (P = 0.0003).

Conclusion

Acetabular morphology is associated with GTPS and the absence of bursitis was proved to be clinically relevant. Peritrochanteric edema alone was not associated with local pain.     

温针灸结合推拿治疗肩周炎的临床疗效观察72例

目的观察温针灸结合推拿治疗肩周炎的临床疗效,寻找治疗肩周炎的有效方法。方法将72例肩周炎患者随机分成治疗组和对照组各36例。治疗组采用局部取穴与循经取穴相结合的方法,温针灸患侧肩、肩、肩前等穴,并结合推拿点、按、揉、捏等手法治疗;对照组单纯采用温针灸治疗。两组均治疗1次/d,10d为1个疗程,2个疗程为1个观察周期。结果总显效率治疗组为97.22%,对照组为80.56%,治疗组明显高于对照组;经3～6个月随访,治疗组远期疗效优于对照组。结论温针灸结合推拿疗法具有温经散寒,疏通经络,活血止痛之功效。温针灸结合推拿治疗肩周炎其疗效优于单纯采用温针灸治疗。温针灸结合推拿治疗肩周炎具有疗程短、见效快、安全可靠、患者易于接受等优点,临床实用价值较大,值得推广应用。