Castriota-Scanderbeg A, Orsi E, De Micheli V, Pedrazzi G, Letico M, Coppi M
Servizio di Radiologia Pediatrica, Ospedale Infantile C. Arrigo, Alessandria.
Radiol Med. 1993 Dec;86(6):808-14.
Fifty-seven subjects aged 1.5-14 years (mean: 6.5; standard deviation: 3.3) complaining of hip pain and/or limp underwent clinical, US and radiologic examinations on admission and after variable time intervals. Twenty-eight of them were found to be affected with transient synovitis, 2 with rheumatic fever, 2 with slipped capital femoral epiphysis and 5 with Legg-Calvè-Perthes disease. The extant 20 subjects with normal US and X-ray findings were diagnosed as having irritable hip without effusion. No false-negative results were obtained from US (100% sensitivity), whereas X-ray provided false-negative results in 28 of 37 patients with hip disorders other than irritable hip without effusion (24.3% sensitivity). No significant difference in the extent of hip joint effusion was found at US between the various groups. In the transient synovitis group, joint effusion was apparent on X-ray image in 3 of 28 patients, in whom the effusion was significantly more severe than in the extant 25 patients. Capsular joint effusion resolved more rapidly in transient synovitis than in Legg-Calvè-Perthes disease. The patients with both rheumatic fever and transient synovitis exhibited the most rapid onset of symptoms. On the basis of our results, we suggest that each patient complaining of hip pain and/or limp should undergo US first and that X-rays be performed second, in selected cases only.
57名年龄在1.5至14岁之间（平均年龄：6.5岁；标准差：3.3）主诉髋关节疼痛和/或跛行的患者在入院时以及不同时间间隔后接受了临床、超声和放射学检查。其中28名被诊断为暂时性滑膜炎，2名患有风湿热，2名患有股骨头骨骺滑脱，5名患有Legg-Calvè-Perthes病。其余20名超声和X线检查结果正常的患者被诊断为无积液的髋关节疼痛。超声检查未出现假阴性结果（敏感性100%），而在37名除无积液的髋关节疼痛外的髋关节疾病患者中，X线检查出现了28例假阴性结果（敏感性24.3%）。各检查组之间超声检查发现的髋关节积液程度无显著差异。在暂时性滑膜炎组中，28名患者中有3名在X线影像上可见关节积液，其积液程度明显重于其余25名患者。暂时性滑膜炎组的关节囊积液比Legg-Calvè-Perthes病组消退得更快。患有风湿热和暂时性滑膜炎的患者症状发作最为迅速。基于我们的研究结果，我们建议，对于每一位主诉髋关节疼痛和/或跛行的患者，应首先进行超声检查，仅在特定情况下进行第二次X线检查。
