Andjelković Zoran, Mladenović Desimir
Department of Orthopedic Surgery and Traumatology, General Hospital Leskovac, Leskovac, Serbia.
Vojnosanit Pregl. 2013 Mar;70(3):259-66. doi: 10.2298/vsp110727038a.
BACKGROUND/AIM: Femoroacetabular impingement, a pathophysiological mechanism of small morphological changes of the hip leads to early arthritic changes. The aim of this study was to present a simple method for the quantification of femoral head and neck junction in patients with cam form of femoroacetabular impingement, in standardized anteroposterior and profile DUNN 90 radiograms of the hips.
In standardized anteroposterior and profile DUNN 90 images of the hips we determined the angle of 2 alpha, defined by our own original method. We tested 141 hips in 81 patients without clinical signs of femoroacetabular impingement, and 153 hips in 76 patients with clinically clear signs of femoroacetabular impingement.
The value of the angle 2 alpha in anteroposterior hip radiograms was on average 113.7 degrees for the patients with clinical symptoms of impingement, and 84.2 degrees for the control group of patients (p < or = 0.0001), and in DUNN 90 profile radiography of the hip, the value of 2 alpha angle in the patients group was 97.2 degrees, and 74.6 degrees in the control group (p < or = 0.0001). The proposed method of determining the angle 2 alpha showed a high level sensitivity (97.8%) and specificity (98.7) and positive predictive value (98.6%). It was false positive in only 1.3%, and false negative in 2.12% of patients.
Using standardized anteroposterior and profile radiographs of the hips, and without determination of femoral neck axis in patients with femoroacetabular impingement with the cam effect at the junction of the femoral head and neck, we proposed the method of measuring joint abnormalities of femoral head and neck junction, very capable to predict the disease development in an asymptomatic risk group of patients and high sensitive in the diagnosis of the disease in the group of patients.
背景/目的：股骨髋臼撞击症是一种髋关节微小形态变化的病理生理机制，可导致早期关节炎改变。本研究的目的是在标准化的髋关节前后位和DUNN 90侧位X线片中，介绍一种用于量化凸轮型股骨髋臼撞击症患者股骨头与颈交界处的简单方法。
在标准化的髋关节前后位和DUNN 90侧位图像中，我们采用自己的原创方法确定2α角。我们对81例无股骨髋臼撞击症临床体征患者的141个髋关节，以及76例有明确股骨髋臼撞击症临床体征患者的153个髋关节进行了检测。
有撞击症临床症状患者的髋关节前后位X线片中2α角的平均值为113.7度，对照组患者为84.2度（p≤0.0001）；在髋关节DUNN 90侧位X线片中，患者组2α角的值为97.2度，对照组为74.6度（p≤0.0001）。所提出的确定2α角的方法显示出高灵敏度（97.8%）、特异性（98.7%）和阳性预测值（98.6%）。仅1.3%的患者出现假阳性，2.12%的患者出现假阴性。
对于股骨头与颈交界处存在凸轮效应的股骨髋臼撞击症患者，使用标准化的髋关节前后位和侧位X线片，无需确定股骨颈轴线，我们提出了测量股骨头与颈交界处关节异常的方法，该方法非常能够预测无症状风险组患者的疾病发展，并且在患者组疾病诊断中具有高灵敏度。
