血友病性骨关节病X线诊断(附18例报告)

目的:探讨血友病性骨关节病X线特点,以提高对本病的认识。方法:回顾性分析18例血友病性骨关节病的X线表现,结合文献进行分析。结果:18例共累及36个关节,其中膝关节25个,踝关节10个,肩关节1个。关节囊软组织肿胀、密度增高15例,软组织内斑片状钙化3例,关节囊内血肿3例,关节周围软组织及远端肢体肌肉萎缩3例。关节间隙明显狭窄11例,轻度狭窄5例,关节间隙轻度增宽1例,无明显狭窄1例。关节面硬化、凹凸不平16例,无明显改变2例。股骨髁间凹增宽加深14例,骨骺骨端增粗变方、骨干变细11例,髌骨呈方形5例,骨质囊变9例,骨质疏松15例。并发假性骨肿瘤2例。结论:血友病性骨关节病好发于膝部,骨端骨骺增大变方、骨干变细,股骨髁间凹增宽加深,髌骨呈方形和血友病性假肿瘤表现具有特征性。

Radiographic Diagnostics of Hemophilic Arthropathy: an Analysis of 18 Cases

Objective:To study the X-ray features and to improve the diagnostic knowledge of hemophilic arthropathy.Methods:The X-ray manifestations of 18 cases of hemophiliacs wirh arthropathy were retrospectively analyzed.Results:36 joints were involved,including 25 knee joints,10 ankle joints and 1 shoulder joint in these 18 cases of hemophilia.In our collection,X-ray signs of haemophilic arthropathy were as follows:swelling of the joint capsules and periarticular soft tissue with increased density in 15 cases,patches of calcification in the soft tissue in 3 cases,atrophy of the periarticular soft tissue in 3 cases,narrowing of the articular spaces in 11 cases,sclerotic changes of the articular surfaces in 16 cases,enlarged intercondylar fossae of distal femur in 14 cases,broadened metaphyses and enlarged as well as square-shaped epiphyses in 11 cases,cystic changes of bones in 9 cases,square-shaped patella in 5 cases and haemophilic pseudotumors in 2 cases.Concusion:Knee joint was the frequently involved joint by haemophilia.The X-ray signs of broadened metaphyses,square and enlarged epiphyses,thinning of bone shafts,square patellas,enlarged intercondylar fossae and haemophilic pseudotumors of the bone were the characteristic signs of haemophilic arthropathy.