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无症状非运动员人群中股骨髋臼撞击综合征影像学表现的患病率

Prevalence of Radiographic Signs of Femoroacetabular Impingement in Asymptomatic Patients and Non-Athletes.

作者信息

Garcia André Sousa, Gobetti Murilo, Tatei Anderson Yutaka, Falótico Guilherme Guadagnini, Arliani Gustavo Gonçalves, Puertas Eduardo Barros

机构信息

Escola Paulista de Medicina (EPM), Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2019 Feb;54(1):60-63. doi: 10.1016/j.rbo.2017.11.004. Epub 2019 Mar 1.

Abstract

OBJECTIVE

Femoroacetabular impingement has been described as an anatomical variation of the proximal femur and/or acetabular rim, impinging the hip joint. A portion of the population asymptomatic in the hip may present radiographic changes from femoroacetabular impingement. The aim of the present study was to evaluate the prevalence of these signs in asymptomatic and sedentary males.

METHODS

This was a clinical, observational, primary, cross-sectional, controlled study. A total of 32 male volunteers aged between 18 and 40 years, asymptomatic in the hip and sedentary, were selected from a university hospital orthopedic emergency room. All patients underwent standard anteroposterior pelvic radiographs. The measurements of the alpha angle, the retroversion index, the ischial spine signal, and the posterior wall sign were analyzed.

RESULTS

The mean age was 29 years (18-40 years old). The prevalence of radiographic signs of femoroacetabular impingement using an alpha angle of 67 was of 53.1%; with an alpha angle of 82 , it was of 31.2%. The mean alpha angle was 67 (52.4-88.2 ), with 35.9% of the hips classified as borderline and 6.3% as pathological. The mean alpha angle for the right side was 67.5 (52.5-88.2 ), and, for the left, it was 66.6 (53.1-86.9 ). The mean retroversion index was 0.048 (right side: 0.044; left side: 0.052). The spine signal was positive in 15.6%, and the posterior wall sign, in 20.3% of the cases.

CONCLUSION

This study showed that the prevalence of radiographic signs in a population of asymptomatic and sedentary adult men was high (31.2%). New studies are required to explian the actual clinical significance of this finding.

摘要

目的

股骨髋臼撞击症被描述为股骨近端和/或髋臼缘的解剖变异,会对髋关节造成撞击。一部分髋关节无症状的人群可能会出现股骨髋臼撞击症的影像学改变。本研究的目的是评估这些体征在无症状久坐男性中的患病率。

方法

这是一项临床、观察性、原发性、横断面、对照研究。从大学医院骨科急诊室选取了32名年龄在18至40岁之间、髋关节无症状且久坐的男性志愿者。所有患者均接受标准骨盆前后位X线片检查。分析了α角、后倾指数、坐骨棘信号和后壁征的测量结果。

结果

平均年龄为29岁(18至40岁)。使用α角为67°时,股骨髋臼撞击症影像学体征的患病率为53.1%;α角为82°时,患病率为31.2%。平均α角为67°(52.4至88.2°),35.9%的髋关节被分类为临界状态,6.3%为病理性。右侧的平均α角为67.5°(52.5至88.2°),左侧为66.6°(53.1至86.9°)。平均后倾指数为0.048(右侧:0.044;左侧:0.052)。15.6%的病例坐骨棘信号为阳性,20.3%的病例后壁征为阳性。

结论

本研究表明,无症状久坐成年男性人群中影像学体征的患病率较高(31.2%)。需要新的研究来解释这一发现的实际临床意义。

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本文引用的文献

1
Radiographic Diagnosis of Pincer-Type Femoroacetabular Impingement: A Systematic Review.钳夹型股骨髋臼撞击症的影像学诊断:一项系统评价
Orthop J Sports Med. 2017 May 31;5(5):2325967117708307. doi: 10.1177/2325967117708307. eCollection 2017 May.
2
Femoroacetabular impingement.股骨髋臼撞击症
Rev Bras Ortop. 2016 Oct 19;51(6):621-629. doi: 10.1016/j.rboe.2016.10.006. eCollection 2016 Nov-Dec.
3
Femoroacetabular Impingement: A Review.股骨髋臼撞击症:综述
Sports Med Arthrosc Rev. 2016 Dec;24(4):e53-e58. doi: 10.1097/JSA.0000000000000126.

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