快速破坏性髋关节病的临床及影像学特点分析

目的探讨快速破坏性髋关节病（rapidly destructive hip disease, RDHD）的临床及影像学特点。方法收集2011～11及2012—04住院治疗的2例RDHD临床资料，对其症状、体征、实验室检查以及髋关节X线片、CT及MRI影像学特点进行回顾性分析。结果RDHD多见于高龄患者。髋部疼痛持续加重，口服止痛药缓解不明显，髋关节活动受限。影像学检查提示一个相对正常的髋关节在数月内出现快速、进行性破坏改变，其变化特点与常见的股骨头坏死、髋骨性关节炎等疾病有显著区别；实验室检查结果无特异性，但是具有鉴别意义。结论综合患者的发病情况及临床症状、体征特点，结合髋关节相关影像及其演变特点，在排除其他疾病后，可对RDHD做出正确的诊断，并指导对其进行临床治疗。

Analysis of clinical and imaging characteristics of rapidly destructive hip disease

Objective To investigate the clinical and imaging characteristics of rapidly destructive hip dlsease（RDHD）. MethodS Data of 2 cases who received treatment in our hospital in November 2011 and April 2012 were collected and then retrospective analysis of the characteristics of their ordinary circumstance, clinical symptoms, signs, laboratory results and image information was performed. Results The rapidly destnlctive hip disease occurred in elderly people and caused the persistent, progressive pain which could not be obviously relieved by oral medication, in addition brought the limitation of motion in hip joint; imaging examination suggested a relatively normal hip to be rapidly and constantly damaged in a few months, this characteristic had a significant difference between osteonecrosis of the femoral head and hip arthritis or other diseases; laboratory examination had no specificity but significantly in differential diagnosis. Conclusion The combined characteristics of morbidity situation, clinical symptoms, signs, and imaging can make the correct diagnosis of rapidly destructive hip disease and guide the clinical treatment.