髌股关节轴位静动结合X线投照的临床价值探讨

目的:观察髌股关节轴位在静力性与动力性不同投照角度的条件下进行摄片,来探讨其对髌股关节排列异常的X线诊断价值以提高对病变的检出率。材料与方法:82例(113侧膝关节)髌股关节排列异常患者,进行屈膝30°静力性摄片,和45°,60°动力性分别摄片,然后测量髌骨协调角和外侧髌股角两项参数对髌股关节排列异常的诊断价值进行比较。结果:30°,45°,60°检查时髌股关节排列异常的检出率分别是62.83％,50.44％,78.76％;在30°静力性条件下未能达到诊断标准后经45°,60°动力性条件下的检出率分别是14.28％,61.90％,但45°,60°时又会出现假阴性其假阴性率分别是28.17％,11.27％。结论:髌股关节轴位在静力性与动力性不同投照角度的条件下进行摄片对髌股关节排列异常具有较高的临床诊断价值,静力性摄片是基本检查体位,对在静力性条件下未能达到诊断标准的患者进行动力性检查可提高病变检出率。

Clinical Value of Combination Static with Dynamic Axial View of Patellafemora Joint

Objective To observe X-ray diagnosis and application value of static and dynamic axial view of patellafemora jiont. Methods 113 knees in 82 patients with malalignment of the patellafemora in this study. The radiographic examination includes axial view with the knee in 30,45and 60 of flexion. The congruence angle and lateral patellafemoral angle were measured. Results The detection rate of malalignment of the patellafemoral joint was 62. 83 %, 50. 44 % and 78. 76 % in 30, 45and 60 were taken again to patients which without achieve diagnosis criterion for malalignment of the patellafemoral joint in 30. The detection rate was 14. 28 % and 61. 90 %, but false negative rate was 28. 17 % and 11. 27 % respectively in 45 and 60. Conclusion The static and dynamic axial view of patellafemoral joint is of great value to diagnosis of the malalignment of the patellafemoral joint. The static axial view is essential position. A combination of the static and dynamic axial view of patellafemoral joint can improve the detection rate of malaignment of the patellafemoral joint to the patients without achieve diagnosis criterion in static axial view.