Bensasson M, Dorfmann H, Perez-Busquier M, Solnica J, Mery C, Kahn M F, de Seze S
Rev Rhum Mal Osteoartic. 1975 Jan;42(1):3-11.
The authors analysed radiograms of the hands of 50 patients suffering from primary articular chondrocalcinosis (ACC) and compared them with those of 100 control subjects of similar sex and age. There were 40 women and 10 men, with an average age of 69.6 years (plus or minus 9.82). A chalky incrustation of the semilunar pyramidal interspace was observed in 40 percent of cases. The frequency of this incrustation was next in order of importance to incrustation of the triangular ligament which occurred in 52 percent of cases. The difference from the controls was highly significant (p less than 0.001). Voluminous geodes affecting one or more of the bone of the wrist were present in 20 percent of the patients with ACC and in 5 percent of the controls. The difference was significant (p less than 0.01). Chalky deposits were found in the soft tissues immediately next to a metacarpo-phalangeal articulation in 22 percent of the ACC patients but not in any of the controls. The difference was highly significant (p less than 0.001). These chalky deposits next to metacarpo-phalangeal articulations were always associated with chalky incrustation of the radio-carpal joint. As regards the radiological lesions, considered as being typical images of arthrosis and affecting the trapezo-metacarpal, metacarpo-phalangeal, and interphalangeal articulations, the chondrocalcinosis patients appeared to be more frequently affected than the controls, but the difference was not significant. On the other hand, a type of arthropathy occurs in ACC patients which also resembles an arthrosis radiologically but which was 5 times more frequent in them than in the controls and which in this series occurred without nearby trapezo-metacarpal arthropathy only in ACC patients (16 percent as against 0 percent in the controls: p less than 0.001); this was scapho-trapezial arthropathy. The finding of this kind of radiological lesion, particularly when it is not associated with lesions in the trapezo-metacarpal articulations should indicate the possibility of a diagnosis of ACC and should lead to radiological investigation of other sites.
作者分析了50例原发性关节软骨钙质沉着症(ACC)患者手部的X线片,并将其与100名年龄和性别相仿的对照者的X线片进行比较。患者中有40名女性和10名男性,平均年龄为69.6岁(±9.82)。40%的病例观察到半月锥体间隙有白垩样沉着。这种沉着的发生率仅次于三角韧带沉着,三角韧带沉着发生率为52%。与对照组相比差异极显著(p<0.001)。20%的ACC患者腕部一根或多根骨头出现大量关节腔囊肿,而对照组为5%。差异显著(p<0.01)。22%的ACC患者在掌指关节紧邻的软组织中发现白垩样沉积物,而对照组均未发现。差异极显著(p<0.001)。这些掌指关节旁的白垩样沉积物总是与桡腕关节的白垩样沉着相关。关于被视为典型骨关节炎影像且累及大多角骨-掌骨关节、掌指关节和指间关节的放射学病变,软骨钙质沉着症患者似乎比对照组更易受累,但差异不显著。另一方面,ACC患者会出现一种关节病,其放射学表现也类似骨关节炎,但在ACC患者中的发生率比对照组高5倍,且在本系列中仅在ACC患者中出现而无邻近大多角骨-掌骨关节病(ACC患者为16%,对照组为0%:p<0.001);这就是舟月关节病。发现这种放射学病变,尤其是当它与大多角骨-掌骨关节病变无关时,应提示ACC诊断的可能性,并应导致对其他部位进行放射学检查。