Stumpp P, Roth A
Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Leipzig AöR, Liebigstraße 20, 04103, Leipzig, Deutschland.
Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie Bereich Endoprothetik/Orthopädie, Universitätsklinik Leipzig AöR, Leipzig, Deutschland.
Orthopade. 2018 Sep;47(9):717-721. doi: 10.1007/s00132-018-3621-9.
In patients with hip pain, clinical examination is of only restricted value in the differential diagnosis. Besides a patient's age, their medical history is often helpful in finding the correct diagnosis. Additionally, imaging can give valuable hints for excluding or validating a differential diagnosis. Nowadays, magnetic resonance imaging (MRI) is often used as a primary imaging modality in Germany. These MRIs show a bone marrow edema (BME) in many different pathologies. BME occurs in transitory bone marrow edema and outside of the atraumatic femoral head necrosis, concomitant with coxarthrosis, arthritis, herniation pit, and osteoid osteoma, amongst other conditions. This article describes several frequent differential diagnoses and gives hints on how to find the correct diagnosis.
对于髋关节疼痛患者，临床检查在鉴别诊断中的价值有限。除了患者的年龄外，其病史通常有助于做出正确诊断。此外，影像学检查可为排除或验证鉴别诊断提供有价值的线索。如今，在德国，磁共振成像（MRI）常被用作主要的影像学检查方式。这些MRI在许多不同的病理情况下都显示出骨髓水肿（BME）。BME见于暂时性骨髓水肿以及非创伤性股骨头坏死之外的情况，还伴有髋关节炎、关节炎、疝窝和骨样骨瘤等其他病症。本文描述了几种常见的鉴别诊断，并给出了如何做出正确诊断的提示。
