强直性脊柱炎致骶髂关节炎的X线与CT诊断

目的 评估X线对强直性脊柱炎患者骶髂关节炎的诊断价值。方法 对临床表现为缓慢加重的腰骶部及双髋部疼痛、压痛及活动受限者68例，进行脊柱正侧位或加摄斜位X线片。其中，6例临床怀疑骶髂并节病变者又经CT检查。结果 单侧骶髂关节改变为28例，双侧骶髂关节改变40例。怀疑骶髂关节病变6例，轻度骶髂关节炎34例，中度骶髂关节炎20例，重度骶髂关节炎8例。68例中59例HLA—B27抗原阳性。结论 X线正位加左、右斜位平片能对大部分骶髂关节炎作出诊断，尤其是左、右斜位更有利于观察骶髂关节病变。对于骶髂关节炎的早期诊断，CT优于X线平片。

Diagnosis of sacroiliitis accompaning ankylosing spondylitis with X- ray and CT

Objective To assess the usefulness of X-ray and CT for diagnosing and differentiating the sacroiliitis accompaning ankylosing spondylitis(AS).Methods Sixty-eight patients with clinically presented as slowly aggravating pains,pressor pains,and activity limit of the lumbosacral portio and both hips underwent anteroposterior and oblique radiographs of the spine.6 patients with suspected lesions of the sacroiliac joints underwent additional CT scans of the spine.Results The pathologic changes of unilateral and bilateral sacroiliac joints were found in 28 and 40 cases,respectively.Among all patients,the suspected lesions of sacroiliac joints were found in 6 cases,mild sacroiliitis in 34,moderate sacroiliitis in 20,and severe sacroiliitis in 8.The positive HLA-B27 antigen was found in 59 of 68 patients.Conclusion The anteroposterior and oblique radiographs of the spine can correctly diagnose most sacroiliitis,especially left and right oblique radiographs are useful to observe the lesions of the sacroiliac joint.For the diagnosis of early sacroiliitis,CT is superior to conventional radiography.