Shih T T, Su C T, Chiu L C, Erickson F, Hang Y S, Huang K M
Department of Radiology, National Taiwan University Medical College and Hospital, Taipei, R.O.C.
J Formos Med Assoc. 1993 Aug;92(8):737-44.
Thirty-six hips were studied because of significant hip pain. Radiography of the hip and bone scintigraphy showed subtle changes. Magnetic resonance imaging (MRI) was performed using a 1.5 Tesla superconductive unit. All MRI findings were confirmed by surgical or pathologic results. Twenty-nine hips had a single lesion, including: infection (one), fracture (eight), avascular necrosis of the femur(two), or contralateral hip (four), transient osteoporosis (six), osteoporosis (one), post-irradiation myositis (one), metastasis (four), and synovitis (two). Twenty-six lesions (89.6%) appeared normal on the radiographs of the hip, while three lesions (10.4%) showed only osteoporotic change. Another seven hips had more than one lesion, including: avascular necrosis and fracture (four), fracture foci (two), and metastasis and fracture (two). Radiography of the hip showed either a negative finding or detected only a single lesion, missing other important pathologic foci. MRI is extremely sensitive to alterations in the bone marrow that may represent pathology occult to plain radiography and bone scintigraphy of the hips. For diagnosis and treatment planning, MRI of the hips should be performed early in patients with persistent pain and negative radiography findings.
对36例因严重髋关节疼痛而进行研究。髋关节X线摄影和骨闪烁显像显示有细微变化。使用1.5特斯拉超导设备进行磁共振成像（MRI）检查。所有MRI检查结果均经手术或病理结果证实。29例髋关节有单个病变，包括：感染（1例）、骨折（8例）、股骨缺血性坏死（2例）、对侧髋关节病变（4例）、暂时性骨质疏松（6例）、骨质疏松（1例）、放疗后肌炎（1例）、转移瘤（4例）和滑膜炎（2例）。26个病变（89.6%）在髋关节X线片上表现正常，而3个病变（10.4%）仅显示骨质疏松改变。另外7例髋关节有不止一个病变，包括：缺血性坏死和骨折（4例）、骨折灶（2例）以及转移瘤和骨折（2例）。髋关节X线摄影要么显示阴性结果，要么仅检测到单个病变，遗漏了其他重要的病理病灶。MRI对骨髓变化极为敏感，这些变化可能代表髋关节X线平片和骨闪烁显像隐匿的病理情况。对于诊断和治疗方案的制定，对于持续疼痛且X线摄影结果为阴性的患者，应尽早进行髋关节MRI检查。
