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膝关节骨关节炎:影像学与关节镜检查结果的相关性

Osteoarthritis of knee: correlation between radiographic and arthroscopic findings.

作者信息

AlOmran Abdullah S

机构信息

College of Medicine, King Faisal University, Dammam, Saudi Arabia.

出版信息

Int Surg. 2009 Jul-Sep;94(3):269-72.

PMID:20187524
Abstract

The objective of this study was to correlate radiologic changes to arthroscopic findings in patients with osteoarthritis of the tibiofemoral joint. The study group consisted of 105 patients, 52 men and 53 women, with a mean age of 51 +/- 9.3 years (range, 39-83 years), with symptomatic tibiofemoral joint osteoarthritis (TFOA). X-rays were graded according to Kellgren and Lawrence grading (KLG) by 2 independent board-certified radiologists. All patients had arthroscopy, and findings were recorded and analyzed per Outerbridge classification (OC). Approval of the Institutional Research and Ethical Committee was obtained. Statistical analysis was done using the Statistical Package for the Social Sciences, version 17 (SPSS Inc., Chicago, IL, USA). In men, the correlation of KLG to OC was more than 75% in grade II and joints appeared as grade IV, but with grades I and III, it was 66% and 57% (P = 0.05). In men in KLG groups I and III, the joints appeared to have milder affliction, but arthroscopy revealed otherwise. In women, the only correlation was of KLG grade IV to OC grade IV. In women, joint affliction was more severe than was predicted by the KLG (P = 0.01). This study shows that radiologic lagging occurs behind arthroscopic findings, especially in women and in apparent early arthritis in roentgenograms (lower radiologic grades). X-rays of the knee per se might give a false impression of a milder disease.

摘要

本研究的目的是将胫股关节骨关节炎患者的放射学改变与关节镜检查结果进行关联。研究组由105例患者组成,其中男性52例,女性53例,平均年龄51±9.3岁(范围39 - 83岁),患有症状性胫股关节骨关节炎(TFOA)。X线片由2名独立的具有委员会认证资格的放射科医生根据Kellgren和Lawrence分级(KLG)进行分级。所有患者均接受了关节镜检查,并根据Outerbridge分类(OC)记录和分析检查结果。获得了机构研究与伦理委员会的批准。使用社会科学统计软件包第17版(SPSS Inc.,美国伊利诺伊州芝加哥)进行统计分析。在男性中,KLG与OC的相关性在II级时超过75%,关节表现为IV级,但在I级和III级时,相关性分别为66%和57%(P = 0.05)。在KLG I级和III级的男性中,关节看似受累较轻,但关节镜检查结果却并非如此。在女性中,唯一的相关性是KLG IV级与OC IV级。在女性中,关节受累程度比KLG预测的更严重(P = 0.01)。本研究表明,放射学表现滞后于关节镜检查结果,尤其是在女性以及X线片显示为明显早期关节炎(放射学分级较低)的情况中。膝关节X线片本身可能会给人一种疾病较轻的错误印象。

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