骨盆骶髂关节旁致密线的测量与臀肌挛缩

背景：临床中多发现以非臀肌挛缩症就诊患者的骨盆平片上骶髂关节旁靠近髂骨翼处存在纵行致密线影,经仔细体格检查及手术病理证实为臀肌挛缩症。　 目的：分析骶髂关节旁致密线与臀肌挛缩症之间的关系及其在诊疗中的作用。 方法：分析50例臀肌挛缩症患者的骨盆平片,其中45例以臀大肌挛缩为主,5例以臀中肌挛缩为主。并以100例非臀肌挛缩症患者的骨盆平片作对照。 结果与结论：臀肌挛缩组42例骨盆平片见骶髂关节旁致密线,位于髂骨翼部骶髂关节水平。对照组仅3例见骶髂关节旁致密线。臀肌挛缩组骶髂关节旁致密线的出现率较对照组明显增多(P < 0.01);以臀中肌挛缩组中有4例表现为骨盆倾斜,仅1例可见髂骨致密线;而臀大肌挛缩组中有40例可见髂骨致密线,两组间差异有非常显著性意义(P < 0.01),说明致密线的形成系臀大肌挛缩所致,而与臀中肌挛缩无关。提示骨盆平片上骶髂关节旁致密线是影像学检查诊断臀肌挛缩症的一种有价值征象。

Hyperdense line by sacroiliac joints on pelvic plain film and gluteal muscle contracture

BACKGROUND:Hyperdense line has been found at sacroiliac joints on pelvic plain film of patients with non-gluteal muscle contracture (GMC), who are finally confirmed as GMC by physical examination and pathology. OBJECTIVE:To explore the relationship between the hyperdense line by sacroiliac joints and GMC and to investigate the effect of the hyperdense line in diagnosis and treatment for GMC. METHODS:The pelvic plain films of 50 cases of GMC, including 45 involving gluteus maximus muscle and 5 involving gluteus medius muscle, were analyzed. Those of 100 individuals with non-GMC served as control. RESULTS AND CONCLUSION:The hyperdense line by sacroiliac joints was found on the pelvic plain film in 42 cases of GMC group and 3 in control group. The incidence rate of hyperdense line was significantly greater in GMC group compared with control group (P < 0.01); 4 cases presented pelvic tilt in gluteal mediums main contracture group, but only 1 had the hyperdense line, while 40 cases in gluteus maximus main contracture group presented the hyperdense line (P < 0.01), indicating a correlation between hyperdense line and gluteus maximus main contracture. Results show that the hyperdense line by sacroiliac joints on pelvic plain film can be used as a sign to diagnose GMC.