切换至 "中华医学电子期刊资源库"

中华关节外科杂志(电子版) ›› 2018, Vol. 12 ›› Issue (06) : 887 -890. doi: 10.3877/cma.j.issn.1674-134X.2018.06.026

所属专题: 文献

个案报道

X线不宜单独作为膝骨关节炎的评价标准
张海东1, 滕涛1,()   
  1. 1. 100062 北京市普仁医院骨科
  • 收稿日期:2018-06-11 出版日期:2018-12-01
  • 通信作者: 滕涛

X-ray should no longer be exclusive criteria for assessment of knee osteoarthritis

Haidong Zhang1, Tao Teng1()   

  • Received:2018-06-11 Published:2018-12-01
  • Corresponding author: Tao Teng
引用本文:

张海东, 滕涛. X线不宜单独作为膝骨关节炎的评价标准[J]. 中华关节外科杂志(电子版), 2018, 12(06): 887-890.

Haidong Zhang, Tao Teng. X-ray should no longer be exclusive criteria for assessment of knee osteoarthritis[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2018, 12(06): 887-890.

图1 膝关节负重位正侧位片。图A为双膝关节负重位正位片,示右膝内侧关节间隙轻度狭窄,外侧未见明显狭窄,边缘少量骨赘形成;图B为右膝关节侧位片,示关节退变,边缘轻度骨赘增生
图2 右膝关节MRI T2WI冠状位和矢状位。图A为右膝关节MRI T2WI冠状位,示外侧关节腔内积液,内为高信号,半月板及软骨结构显示不清;图B为膝关节MRI T2WI矢状位,示后外侧内高信号,软骨及半月板结构显示不清
图3 关节镜术中所见胫股关节外侧,示外侧关节间隙软骨完全消失,软骨下骨裸露,胫骨平台轻度塌陷
表1 软骨病变Recht分级与Outerbridge分级法对照[10]
图4 软骨病变的标准化分级系统示意图
[1]
Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010[J]. Lancet, 2012, 380(9859): 2163-2196.
[2]
Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II[J]. Arthritis Rheum, 2008, 58(1): 26-35.
[3]
Zhang Y, Jordan JM. Epidemiology of osteoarthritis[J]. Clin Geriatr Med, 2010, 26(3): 355-369.
[4]
Wallace IJ, Worthington S, Felson DT, et al. Knee osteoarthritis has doubled in prevalence since the mid-20th century[J]. Proc Natl Acad Sci U S A, 2017, 114(35): 9332-9336.
[5]
王瀚,马敏,尹峰.脂肪干细胞治疗骨关节炎的研究进展及应用前景[J/CD].中华关节外科杂志(电子版),2016,10(3):337-340.
[6]
Kellgren J, Lawrence J. Radiological assessment of osteoarthritis[J]. Ann Rheum Dis, 1957, 16(4): 494-501.
[7]
Piperno M, Hellio LM, Conrozier T, et al. Quantitative evaluation of joint spacewidth in femorotibial osteoarthritis:comparison of three radiographicviews[J]. Osteoarthritis Cartilage, 1998, 6(4): 252-259.
[8]
Hutt JR, Craik J, Phadnis J, et al. Arthroscopy for mechanical symptoms in osteoarthritis: a cost-effective procedure[J]. Knee Surg Sports Traumatol Arthrosc, 2015, 23(12):3545-3549.
[9]
黄越,王岩,李伟.关节镜治疗膝关节骨关节炎的疗效及其影响因素研究[J].海南医学,2017,28(24):3972-3976.
[10]
Recht MP, Kramer J, Marcelis S, et al. Abnormalities of articular cartilage in the knee: analysis of available Mr techniques[J]. Radiology, 1993, 187(2): 473-478.
[11]
Recht MP, Piraino DW, Paletta GA, et al. Accuracy of fat-suppressed three-dimensional spoiled gradien techoFLASH MR imaging in the detection of patellofemoral articularcartilage abnormalities[J]. Radiology, 1996, 198(1): 209-212.
[12]
Brittberg M, Winalski CS. Evaluation of cartilage injuries and repair[J]. J Bone Joint Surg Am, 2003, 85A(2): 58-69.
[13]
Peterfy CG, Guermazi A, Zaim S, et al. Whole-organ magnetic resonance imaging score (WORMS) of the knee in osteoarthritis[J]. Osteoarthritis Cartilage, 2004, 12(3): 177-190.
[14]
Stehling C, Lane NE, Nevitt MC, et al. Subjects with higher physical activity levels have more severe focalknee lesions diagnosed with 3T MRI:analysis of a non-symptomaticcohort of the osteoarthritis initiative[J]. Osteoarthritis Cartilage, 2010, 18(6): 776-786.
[15]
吴春营,樊波,李皎,等.MRI在诊断关节软骨炎症上的应用[J].国外医学临床放射学分册,1997,12(2):91-95.
[16]
Bredella MA, Tirman PF, Peterfy CG, et al. Accuracy of T2-weighted fast spin-echo MR imaging with fat saturation in detecting cartilagedefects in the knee: comparison with arthroscopy in 130 patients[J]. AJR Am J Roentgenol, 1999, 172(4): 1073-1080.
[17]
Crema MD, Roemer FW, Marra MD, et al. Articular cartilage in the knee: current MR imaging techniques and applications in clinical practice and research[J]. Radiographics, 2011, 31(1): 37-61.
[18]
Hayashi D, Guermazi A, Crema MD, et al. Imaging in osteoarthritis: what have we learned and where are we going?[J]. Minerva Med, 2011, 102(1): 15-32.
[19]
Hayashi D, Guermazi A, Hunter DJ. Osteoarthritis year 2010 in review: imaging[J]. Osteoarthritis Cartilage, 2011, 19(4): 354-360.
[20]
钟学兰.MRI对膝骨关节炎的早期诊断价值[J].现代医用影像学,2016,25(6):1108-1110.
[21]
Link TM, Steinbach LS, Ghosh S, et al. Osteoarthritis: MR imaging findings in different stages of disease and correlation with clinical findings[J]. Radiology, 2003, 226(2): 373-381.
[22]
Felson DT, Chaisson CE, Hill CL, et al. The association of bone marrow lesions with pain in knee osteoarthritis[J]. Ann Intern Med, 2001, 134(7): 541-549.
[23]
Kornaat PR, Bloem JL, Ceulemans RY, et al. Osteoarthritis of the knee:association between clinical features and MR imaging findings[J]. Radiology, 2006, 239(3): 811-817.
No related articles found!
阅读次数
全文


摘要