Lequesne M, Spartien O, Fauchet M
Rev Rhum Mal Osteoartic. 1981 May;48(5):423-30.
The authors have only reported cases responding to the following criteria: A) necessarily: 1) Clinical appearance of algodystrophy. 2) Intense hyperfixation of the bone scan. 3) X rays repeated a sufficient number of times always normal and submitted to the judgement of six rheumatologists not forewarned, to eliminate the subjective factor in the diagnosis of normality. 4) Clinical cure within the usual period. 5) Return to normal of the bone scan. B) Eventually: 6) Proved decalcifying algodystrophy from another joint site in the past history. 7) Histological appearance compatible with algodystrophy on bone biopsy. Four cases are presented (hip one case, knee two cases, ankle one case) which fulfill the five necessary criteria. The course seems shorter than in the classical decalcifying forms: 2 months instead of 4 1/2 months on average for the hip; 5 months instead of 7 months on average for the knee; 5 months instead of 12 months on average for the foot. This short course is in favour of the theory of early and rapid reconstructive bone changes, which do not leave the algodystrophy the time to demineralise the bone more than 30 to 50% which is the time necessary for the increased radiographic bone transparency to become clear.
A)必要条件:1)骨营养不良的临床表现。2)骨扫描有强烈的放射性浓聚。3)多次重复X线检查始终正常,并提交给六位不知情的风湿病学家判断,以消除诊断正常时的主观因素。4)在通常时间内临床治愈。5)骨扫描恢复正常。B)可能条件:6)既往病史中有其他关节部位已证实的脱钙性骨营养不良。7)骨活检的组织学表现与骨营养不良相符。本文介绍了4例(髋关节1例,膝关节2例,踝关节1例)符合上述5项必要标准的病例。病程似乎比典型的脱钙形式短:髋关节平均2个月,而不是4个半月;膝关节平均5个月,而不是7个月;足部平均5个月,而不是12个月。这种短病程支持早期快速重建性骨改变的理论,即这种改变不会让骨营养不良有时间使骨脱矿超过30%至50%,而这是X线片上骨透明度增加变得明显所需的时间。