Harris C M, Baum J
University of Rochester School of Medicine and Dentistry, New York 14642.
J Bone Joint Surg Am. 1988 Jul;70(6):821-33.
Thirty-five children who had rheumatoid arthritis were followed for three to twenty-two years. Four categories of involvement of the hip were seen. In the first group, thirteen patients had mild disability and slight radiographic changes. In six of those patients the disease was in remission at the time of writing, and the patients were asymptomatic. In the second group, two patients had episodic disability that correlated with the activity of the disease. In the third group, fourteen patients had progressive disability and radiographic changes. Fifty-five of the fifty-nine procedures that were performed on the hip and knee in this series were done on those fourteen patients. In the fourth group, six patients had dramatic clinical and radiographic findings but, at the time of the latest follow-up, had little functional disability. In all six of these patients, the disease was in remission. In the children in this study, protrusio acetabuli was more cephalad than has been found in adults who have rheumatoid arthritis. All of the children had psychosocial problems, but they responded well to counseling. These problems influenced the timing of the surgical treatment.
35名患有类风湿性关节炎的儿童接受了3至22年的随访。观察到髋关节受累的四种类型。在第一组中，13名患者有轻度残疾和轻微的影像学改变。其中6名患者在撰写本文时疾病处于缓解期，且无症状。在第二组中，2名患者有发作性残疾，与疾病活动相关。在第三组中，14名患者有进行性残疾和影像学改变。该系列中对髋关节和膝关节进行的59例手术中有55例是针对这14名患者进行的。在第四组中，6名患者有显著的临床和影像学表现，但在最近一次随访时几乎没有功能残疾。在这6名患者中，疾病均处于缓解期。在本研究的儿童中，髋臼内陷比类风湿性关节炎成人患者中发现的情况更靠头侧。所有儿童都有心理社会问题，但他们对咨询反应良好。这些问题影响了手术治疗的时机。
