Ficat P, Arlet J, Mazières B
Sem Hop. 1975 Jun 14;51(28):1907-16.
The authors report the results of 19 functional investigations carried out for osteochondritis in 11 cases, and osteonecrosis of the knee in 8 cases. The 8 cases of osteonecrosis all had hemodynamic disorders with increased pressure in the bone marrow and stasis due to circulatory obstruction. On the other hand, 5 cases of osteochondritis out of the 11 explored had no disturbance of marrow blood supply. However, of the 6 cases of osteochondritis with vascular disorders, there were 5 who had some other reason which might explain the disorder blood supply within the bone. It thus seems that one may contrast two types of disease: -One, characterized by an intra-osseous circulatory disorder for which one might reserve the terms osteonecrosis, which occurs in patients aged over 60 years, but which may be observed in juvenile forms. - The other, characterised by the absence of any hemodynamic disturbance and in which the foreign body seems to result from a very localised disorder which does not affect the bone marrow blood supply. One may use here the term, osteochondritis. We propose to substitute this physiopathological classification for the classical division based on age and on X-rays. Investigation of the blood supply of the bone, permits, as with strontium, early diagnosis at a pre-radiological stage.
作者报告了对11例骨软骨炎和8例膝关节骨坏死进行的19项功能检查结果。8例骨坏死均存在血液动力学紊乱，骨髓压力升高且因循环阻塞导致淤血。另一方面，在11例接受检查的骨软骨炎患者中，有5例骨髓血液供应未受干扰。然而，在6例伴有血管紊乱的骨软骨炎病例中，有5例存在其他可能解释骨内血液供应紊乱的原因。因此，似乎可以区分两种类型的疾病：一种以骨内循环紊乱为特征，对于这种情况，可以保留骨坏死这一术语，其发生在60岁以上的患者中，但也可能以青少年形式出现；另一种以不存在任何血液动力学紊乱为特征，其中异物似乎源于非常局部的紊乱，不影响骨髓血液供应。这里可以使用骨软骨炎这一术语。我们建议用这种病理生理学分类取代基于年龄和X线的传统分类。对骨血液供应的研究，与锶检查一样，能够在放射学前期进行早期诊断。
