Matar Wadih Y, May Olivier, Raymond François, Beaulé Paul E
Division of Orthopaedic Surgery, University of Ottawa, Ottawa Hospital-General Campus, Critical Care Wing 1646, 501 Smyth Road, Ottawa, ON, Canada K1H 8L6.
Clin Orthop Relat Res. 2009 Mar;467(3):676-81. doi: 10.1007/s11999-008-0662-0. Epub 2008 Dec 17.
Femoroacetabular impingement (FAI) has recently been recognized as a cause of hip pain, labral tears, and cartilage damage in young adults. We determined the sensitivity and specificity of bone scans in diagnosing FAI and describe its findings on nuclear imaging. We prospectively followed 25 patients with hip pain (four bilateral) of greater than 6 months' duration and a positive impingement sign (IS). All patients had plain radiographs and a three-phase bone scan followed by single-photon emission computed topographic (SPECT) images of both hips. We presumed patients had FAI if they had all three of the following findings: hip pain, positive IS, and diagnostic radiographs. Forty-six of the 50 hips had bony abnormalities on radiographs and 26 hips were diagnosed with FAI according to our criteria. Twenty-two of these 26 hips showed an increased uptake on SPECT representing true-positives. There were four false-positives, nine false-negatives, and 15 true-negatives. Sensitivity of bone SPECT was 84.7%, specificity 62.5%, positive predictive value 71%, and negative predictive value 78.9%. Focal uptake was localized to the superolateral acetabular rim and/or anterolateral femoral head-neck junction consistent with the reported intra-articular cartilage hip damage seen in FAI.
股骨髋臼撞击症（FAI）最近被认为是导致年轻成年人髋关节疼痛、盂唇撕裂和软骨损伤的原因。我们确定了骨扫描在诊断FAI中的敏感性和特异性，并描述了其在核素成像上的表现。我们前瞻性地随访了25例髋关节疼痛患者（4例双侧），病程超过6个月且撞击征（IS）阳性。所有患者均进行了X线平片和三相骨扫描，随后对双侧髋关节进行单光子发射计算机断层扫描（SPECT）成像。如果患者有以下所有三项表现，我们则假定其患有FAI：髋关节疼痛、IS阳性和诊断性X线片表现。50个髋关节中，46个在X线片上有骨质异常，根据我们的标准，26个髋关节被诊断为FAI。这26个髋关节中有22个在SPECT上显示放射性摄取增加，为真阳性。有4例假阳性、9例假阴性和15例真阴性。骨SPECT的敏感性为84.7%，特异性为62.5%，阳性预测值为71%，阴性预测值为78.9%。局灶性摄取定位于髋臼上外侧缘和/或股骨头颈前外侧交界处，与FAI中报道的关节内软骨髋关节损伤一致。
