关节内骨样骨瘤的影像学表现特点

目的:分析关节内骨样骨瘤的临床及影像学表现特点。方法:回顾性分析了17例手术病理证实的关节内骨样骨瘤临床、X线、CT及MR的表现特点。结果:髋关节13例,膝关节1例,肘关节1例,肩关节1例,椎间关节1例。5例具有典型的夜间疼痛加重。17例中X线显示瘤巢6例,周围骨质硬化7例,关节肿胀9例。CT显示瘤巢17例,周围骨质硬化12例,关节肿胀11例。14例行MR检查,显示瘤巢6例,关节肿胀11例。结论:关节内骨样骨瘤以髋关节好发,其临床表现常不典型。难以显示瘤巢而关节积液明显是X线和MR误诊、漏诊的原因。CT能最好地显示瘤巢,是能获得准确诊断的主要因素。

The imaging features of intra-articular osteoid osteoma

Objective: To analyze clinical characteristic and the imaging features of intra-articular osteoid osteoma. Methods: The clinical and imaging features of 17 cases with intra-articular osteoid osteoma which were proved by surgical pathology were analyzed retrospectively. Results: The joint involved were hip(13 cases), knee(1 case), elbow(1 case), shoulder(1 case) and intervertebral joint(1 case). Only 5 cases had the typical symptom which consists of pain that worsened at night. With radiographic, the nidus were demonstrated in 6 cases, 6 cases had sclerosis around the nidus, 9 cases had associated joint swelling, none had periosteal reaction. In CT scan, the nidus were demonstrated in all cases, 12 cases had the sclerosis around the nidus, 11 cases had associated joint effusion, and with no periosteal reaction. In the 14 cases with MR imaging, the nidus were demonstrated in 6 cases, 11 cases had the associated joint effusion. Conclusion: Most intra-articular osteoid osteomas occur in the hip, the symptom was atypical. It was difficult unable to demonstrate the nidus and the associated joint effusion, on conventional X-ray or MRI and so it was possible to miss the diagnosis, CT scan is the best method to demonstrate the nidus and to achieve the diagnosis.