Department of Radiology, Chung-Ang University Hospital, Seoul, Korea.
Department of Orthopeadic Surgery, Chung-Ang University Hospital, Seoul, Korea.
Korean J Radiol. 2019 Mar;20(3):479-486. doi: 10.3348/kjr.2018.0566.
To identify useful imaging findings for the diagnosis of idiopathic adhesive capsulitis of the hip (ACH) on computed tomography arthrography (CTA).
Twenty-eight consecutive patients (29 hips; 7 males; mean age, 45.7 years; age range, 17-67 years) with ACH from October 2009 to March 2017 and 29 age- and sex-matched control patients from 2014 to 2016 were enrolled. All CTA images were evaluated by 2 radiologists independently for joint distensibility (anterior-posterior [AP] and superior-inferior [SI] joint cavity filling ratios), the presence of contrast filling around the ligamentum teres, and extracapsular contrast leakage. Fisher's exact test, Mann-Whitney U test, analysis of variance, and receiver operating characteristic curves were used for statistical analysis. value less than 0.05 was considered to indicate statistical significance.
The anterior joint cavity was significantly more obliterated in the ACH group (mean size, 3.7-4.0 mm) than in the control group (mean size, 4.8-5.0 mm; < 0.05). The AP filling ratio was also significantly lower in the ACH group (0.6 vs. 1.1; < 0.05) and decreased more as the ACH stage increased (mean anterior joint cavity size: 1.15 mm in stage 3 vs. 4.68 mm in stage 1; < 0.05). Extracapsular contrast leakage was more common in the ACH group (27-28 vs. 20-21; = 0.041 and 0.025, respectively).
On CTA, the anterior joint cavity may have earlier and more marked obliteration than joint cavities on other sides, and may be accompanied by extracapsular contrast leakage in ACH. These CTA findings may be helpful in the diagnosis of ACH.
在 CT 关节造影（CTA）上确定髋关节特发性粘连性关节囊炎（ACH）的有用成像表现。
2009 年 10 月至 2017 年 3 月期间连续 28 例（29 髋；7 例男性；平均年龄 45.7 岁；年龄范围 17-67 岁）接受治疗的 ACH 患者及 2014 年至 2016 年期间的 29 例年龄和性别匹配的对照组患者纳入研究。由 2 名放射科医生对所有 CTA 图像进行独立评估，评估内容包括关节扩张性（前-后[AP]和上-下[S I]关节腔充盈比）、圆韧带周围对比剂充盈情况以及关节外对比剂渗漏。采用 Fisher 确切检验、Mann-Whitney U 检验、方差分析和受试者工作特征曲线进行统计学分析。P 值小于 0.05 表示差异有统计学意义。
ACH 组的前关节腔明显比对照组更闭塞（ACH 组平均大小为 3.7-4.0mm，对照组平均大小为 4.8-5.0mm；P<0.05）。ACH 组的 AP 充盈比也显著较低（0.6 比 1.1；P<0.05），并且随着 ACH 分期的增加而减少（平均前关节腔大小：3 期为 1.15mm，1 期为 4.68mm；P<0.05）。ACH 组的关节外对比剂渗漏更为常见（27-28 例比 20-21 例；=0.041 和 0.025）。
在 CTA 上，ACH 患者的前关节腔可能比其他关节腔更早且更明显地闭塞，并且可能伴有关节外对比剂渗漏。这些 CTA 发现可能有助于 ACH 的诊断。
