Dobón M, Lucía J F, Aguilar C, Mayayo E, Roca M, Solano V, Peña A, Giralt M, Ferrández A
Department of Haematology, Hospital Miguel Servet, Zaragoza, Spain.
Haemophilia. 2003 Jan;9(1):76-85. doi: 10.1046/j.1365-2516.2003.00702.x.
An orthopaedic assessment of the joint status of seven severe haemophiliacs (mean age 12.5 y - range 8.9-15.5) on prophylactic treatment (PT) by magnetic resonance imaging (MRI) and physical examination was carried out. Median duration of PT of these patients was 84 months (range 32-107). A locally designed MRI joint score considering seven parameters (1 - joint effusion, 2 - synovial membrane thickening, 3 - haemosiderin deposits, 4 - joint cartilage injury, 5 - subchondral bone erosion, 6 - subchondral bone cysts, 7 - osteonecrosis) was used (maximum score = 13 points). MRI scans were performed in 17 joints (nine ankles, seven knees and one elbow): mean MRI scores for the affected joints was 5.1. A poor consistency between physical examination and MRI findings or the real extent of joint damage was found (Cohen kappa index 0.320). MRI is a precise non-invasive tool for the assessment of early joint cartilage and synovium pathological changes still undetectable by physical examination or conventional X-rays in the haemophilic setting.
通过磁共振成像（MRI）和体格检查，对7名接受预防性治疗（PT）的重度血友病患者（平均年龄12.5岁，范围8.9 - 15.5岁）的关节状况进行了骨科评估。这些患者PT的中位持续时间为84个月（范围32 - 107个月）。采用了一种本地设计的MRI关节评分系统，该系统考虑七个参数（1 - 关节积液，2 - 滑膜增厚，3 - 含铁血黄素沉积，4 - 关节软骨损伤，5 - 软骨下骨侵蚀，6 - 软骨下骨囊肿，7 - 骨坏死）（最高分 = 13分）。对17个关节（9个踝关节、7个膝关节和1个肘关节）进行了MRI扫描：受影响关节的平均MRI评分为5.1。发现体格检查与MRI结果或关节损伤的实际程度之间一致性较差（科恩kappa指数为0.320）。在血友病患者中，MRI是一种精确的非侵入性工具，可用于评估体格检查或传统X射线仍无法检测到的早期关节软骨和滑膜病理变化。
