| 膝骨关节炎临床症状与X线表现相关性研究 |
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Received:November 07, 2008
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| 期刊信息：《中国骨伤》2009年22卷，第3期，第170-173页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的：探讨膝骨关节炎临床症状与X线片表现的相关性，为临床诊疗提供依据。
方法：收集门诊78例(108膝)膝骨关节炎患者，年龄41～77岁；女65例(89膝),男13例(19膝).对所有病例进行严重性指数(Lequesne膝关节指数)问卷调查，计算严重性指数，并将病例分成轻度组(Lequesne指数≤8)和重度组(Lequesne指数>8).摄负重站立位膝关节正侧位、髌股关节Skyline位X线片，分部位观察评价关节间隙狭窄、骨赘生成、软骨下骨硬化、软骨下囊变，测量下肢力线角及外侧髌股角。对膝骨关节炎严重性与各X线表现进行相关性及回归分析。
结果：膝骨关节炎轻度组和重度组在外侧胫股关节间隙、内侧髌股关节间隙狭窄程度、内侧胫骨骨赘、内侧股骨骨赘、外侧胫骨骨赘、外侧股骨骨赘、内侧滑车骨赘、外侧髌骨骨赘、外侧滑车骨赘、胫骨髁间骨赘程度等方面的差异有统计学意义(P<0.05).Logistic回归分析结果显示外侧股骨骨赘的相伴概率(0.009)最小，Wald值最大(6.779),提示外侧股骨骨赘为判断膝骨关节炎严重性最重要的放射学表现。
结论：评价膝骨关节炎严重性时，关节间隙狭窄与骨赘生成是最有意义的X线表现，其中外侧胫股关节间隙狭窄、内侧髌股关节间隙狭窄、内侧胫骨骨赘、内侧股骨骨赘、外侧胫骨骨赘、外侧股骨骨赘、内侧滑车骨赘、外侧髌骨骨赘、外侧滑车骨赘、胫骨髁间骨赘更加应该予以重视。 |
| [关键词]:骨关节炎,膝 放射摄影术 病理状态,解剖学 诊断 |
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| Study on the relationship between clinical syndromes and X-ray manifestation of knee osteoarthritis |
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Abstract:
Objective: To study the relationship between clinical syndromes and X-ray manifestation of knee osteoarthritis(KOA),so as to provide evidence for clinical diagnosis and treatment.
Methods: Seventy-eight patients(108 knees) with KOA from out-patient clinic of orthopedic were collected, aged from 41 to 77, including 65 females(89 knees) and 13 males (19 knees). Questionnair investigation of Lequesne index was performed among all these patients and the Lequesne index was calculated. And all these patients were divided into two groups,mild group(Lequesne index≤8) and severe group(Lequesne index>8). Weight-bearing anteriorposterior and lateral plain film of knee joint and patellofemoral Skyline plain flim was taken. Joint space narrowing,osteophyte formation,subchondral osteosclerosis and subchondral cystic degeneration were evaluated. The lower limb alignment and lateral patella angle were detected. The correlation of the Lequesne index and X-ray manifestation was analyzed by logistic regression analysis.
Results: There were significant differences between mild and severe groups in the following indexes:lateral tibiofemoral joint space narrowing,the medial retropatellar space narrowing,medial and lateral tibia osteophytes,medial and tibial femur femur osteophytes,medial and lateral trochlea osteophytes,lateral patella osteophytes,tibia introcondylar osteophytes(P<0.05). The results of the logistic regression analysis showed that the lateral femur osteophytes were the most important radiologic manifestation to evaluate the severity degree of KOA,with the minimum associated probability(0.009)and the maximum wald value(6.779).
Conclusion: When evaluating the severity degree of KOA,the joint space narrowing and osteophytes are the most sigenificant radiologic manifestation which includs the lateral tibiofemoral joint space narrowing,the medial retropatellar space narrowing,medial and lateral tibia osteophytes,medial and lateral femur osteophytes,medial and lateral trochlea osteophytes,lateral patella osteophyte,tibial intercondylar osteophyte. |
| KEYWORDS:Osteoarthritis,knee Radiography Pathological conditions,anatomical Diagnosis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 金立昆,谢利民,李玉彬,于潼.膝骨关节炎临床症状与X线表现相关性研究[J].中国骨伤,2009,22(3):170~173 |
| 英文格式: | JIN Li-kun,XIE Li-min,LI Yu-bin,YU Tong.Study on the relationship between clinical syndromes and X-ray manifestation of knee osteoarthritis[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(3):170~173 |
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