Wingstrand H, Egund N, Carlin N O, Forsberg L, Gustafson T, Sundén G
Acta Orthop Scand. 1985 Jun;56(3):204-10. doi: 10.3109/17453678508992995.
Fourteen consecutive children with symptoms of transient synovitis of the hip were examined with sonography regarding intracapsular effusion, with scintimetry regarding blood-flow in the proximal femoral epiphysis (PFE) and with intracapsular pressure recording and aspiration. All patients had an intracapsular effusion. Intracapsular pressure was found to depend on the position of the hip. The mean pressure with hips in extension and inward rotation was 22.6 kPa (170 mm Hg) whereas in 45 degrees of flexion it was 2.3 kPa. In two cases scintimetry demonstrated reduced blood flow to the PFE; after aspiration, isotope uptake returned to normal, indicating that increased intracapsular pressure has a harmful effect on circulation to the PFE. Children with transient synovitis should be treated with the hips in 45 degrees of flexion to reduce intracapsular pressure. Forcing the hip in extension causes a risk of ischaemia of the PFE.
对连续14例有髋关节暂时性滑膜炎症状的儿童进行了超声检查以评估关节囊内积液，进行了闪烁扫描法以评估股骨近端骨骺（PFE）的血流情况，并进行了关节囊内压力记录和抽吸。所有患者均有关节囊内积液。发现关节囊内压力取决于髋关节的位置。髋关节伸展并内旋时的平均压力为22.6 kPa（170 mmHg），而在45度屈曲时为2.3 kPa。在两例病例中，闪烁扫描法显示PFE的血流减少；抽吸后，同位素摄取恢复正常，表明关节囊内压力升高对PFE的血液循环有有害影响。患有暂时性滑膜炎的儿童应将髋关节置于45度屈曲位进行治疗，以降低关节囊内压力。强行伸展髋关节会导致PFE缺血的风险。
