Hu Lintao, Zhang Xianzuo, Kourkoumelis Nikolaos, Shang Xifu
Department of Orthopedics, Affiliated Provincial Hospital of Anhui Medical University, Hefei 230001, China; Department of Orthopedics, The First Affiliated Hospital of USTC (University of Science and Technology of China), Hefei 230001, China.
Department of Orthopedics, The First Affiliated Hospital of USTC (University of Science and Technology of China), Hefei 230001, China.
Ann Palliat Med. 2020 May;9(3):1220-1229. doi: 10.21037/apm.2020.03.17. Epub 2020 Mar 31.
Rapidly destructive arthrosis (RDA) is considered a rare and poorly diagnosed disease but is now seen more frequently in practice due to ageing populations. The most typical radiological features are flat femoral heads, absence of articular cartilage, subchondral bone destruction and signs of joint effusion. These features could be found on X-ray or magnetic resonance imaging (MRI). Surgeons should consider the presence of RDA when patients show rapid femoral head destruction. The purpose of this study is to review the distinct clinical features and successful treatments which may lead to the diagnosis and early handling of RDA. A comprehensive review of the literature was undertaken using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with no language restrictions. Overall 23 publications with 17 detailed cases of RDA met the inclusion criteria. We found that the only prevalent factors associated with RDA were: (I) age greater than 60 years; (II) female gender; (III) presence of underlying systemic diseases such as rheumatoid arthritis, diabetes mellitus or systemic lupus erythematosus. Further studies should be conducted to clarify the histopathology and define the diagnosis as well as the treatment.
快速破坏性关节病（RDA）被认为是一种罕见且诊断不足的疾病，但由于人口老龄化，目前在临床上更为常见。最典型的放射学特征是股骨头扁平、关节软骨缺失、软骨下骨破坏和关节积液迹象。这些特征可在X线或磁共振成像（MRI）上发现。当患者出现股骨头快速破坏时，外科医生应考虑RDA的存在。本研究的目的是回顾可能有助于RDA诊断和早期处理的独特临床特征及成功治疗方法。使用系统评价和Meta分析的首选报告项目（PRISMA）指南，对文献进行了全面回顾，无语言限制。共有23篇出版物和17例RDA详细病例符合纳入标准。我们发现与RDA相关的唯一普遍因素是：（I）年龄大于60岁；（II）女性；（III）存在类风湿关节炎、糖尿病或系统性红斑狼疮等潜在系统性疾病。应进一步开展研究以阐明组织病理学并明确诊断及治疗方法。
