Kotwicki T
Department of Pediatric Orthopedics and Traumatology, University of Medical Sciences, Poznan, Poland.
Stud Health Technol Inform. 2008;140:44-7.
The course of the ossification of the iliac apophysis is considered in adolescent patients with idiopathic scoliosis, under the name of the Risser sign, to determine the remaining spinal growth. Although the iliac crest develops in the three-dimensional space as a complex structure, the iliac apophysis ossification has been assessed only on a one plane frontal spinal radiograph. This study points out the usefulness of the lateral radiograph for the visualization of the whole iliac crest, especially the posterior region which otherwise cannot be observed. Two young female pelvis specimen were examined with anatomical measurements and radiography. Lateral spinal radiographs of 201 girls were analyzed for the iliac apophysis excursion. The measures of the width of the iliac bone beneath the iliac crest revealed one anterior and one posterior thick regions, coupled with an intermediate thin region. The regions of the maximal thickness corresponded to the earliest appearance of the apophysis ossification (Risser 1), while the thin part of the iliac bone corresponded to late appearance of the apophysis ossification (Risser 3-4). The ossification of the posterior part of the crest was best visualized with the lateral radiograph, which was exclusive in showing the posterior superior iliac spine region. On the frontal spinal radiograph the end of the course of the apophysis (Risser 3-4) is usually searched at the level of the sacroiliac joint, while in reality this point was found to be situated more caudal, and accessible for observation on the lateral radiograph.
在患有特发性脊柱侧弯的青少年患者中，髂骨骨骺的骨化过程以里塞尔征（Risser sign）之名进行评估，以确定脊柱剩余的生长情况。尽管髂嵴作为一个复杂结构在三维空间中发育，但髂骨骨骺的骨化仅在脊柱正位X线片的一个平面上进行评估。本研究指出，侧位X线片对于观察整个髂嵴，尤其是否则无法观察到的后部区域很有用。对两具年轻女性骨盆标本进行了解剖测量和X线摄影检查。对201名女孩的脊柱侧位X线片进行了髂骨骨骺偏移分析。髂嵴下方髂骨宽度的测量显示出一个前部厚区和一个后部厚区，以及一个中间薄区。最大厚度区域对应于骨骺骨化最早出现的阶段（里塞尔1期），而髂骨的薄部分对应于骨骺骨化较晚出现的阶段（里塞尔3 - 4期）。嵴后部的骨化在侧位X线片上显示最佳，侧位X线片是唯一能显示髂后上棘区域的片子。在脊柱正位X线片上，通常在骶髂关节水平寻找骨骺骨化过程的终点（里塞尔3 - 4期），而实际上发现这一点位于更靠尾侧的位置，在侧位X线片上可以观察到。
