Barrie H J
Orthopaedic and Arthritic Hospital, Toronto, ON, Canada.
J Rheumatol. 1990 Apr;17(4):448-59.
In a study of 107 femoral heads removed surgically from 91 patients with generalized rheumatoid arthritis (RA), 96 showed rheumatoid stigmata; in 24 of these, fractures were a dominant feature. Of the 11 heads without rheumatoid stigmata, 5 had changes indistinguishable from osteoarthritis (OA), 5 had intracapital fractures and 1 had massive necrosis. The nature of eburnation was analyzed. Attention was drawn to fractures involving all the pillars supporting the subchondral plate and named "the dome shear fracture." The high incidence of fractures (29 of 107) was attributed to steroid therapy. The controls used were femoral heads from 400 patients with OA, 10 with ankylosing spondylitis and 10 treated with steroids for reasons other than RA. In most instances, a clear distinction could be made between RA and OA in the femoral head.
在一项对91例类风湿性关节炎（RA）患者手术切除的107个股骨头的研究中，96个股骨头显示出类风湿特征；其中24个股骨头，骨折是主要特征。在11个没有类风湿特征的股骨头中，5个有与骨关节炎（OA）难以区分的变化，5个有股骨头内骨折，1个有大面积坏死。分析了骨质象牙化的性质。注意到涉及支撑软骨下板的所有支柱的骨折，并将其命名为“穹顶剪切骨折”。骨折的高发生率（107个中有29个）归因于类固醇治疗。所使用的对照是来自400例骨关节炎患者、10例强直性脊柱炎患者和10例因类风湿性关节炎以外的原因接受类固醇治疗患者的股骨头。在大多数情况下，股骨头的类风湿性关节炎和骨关节炎之间可以做出明确区分。
