Lequesne M
Service de Rhumatologie, Hôpital Léopold Bellan, Paris.
Ann Radiol (Paris). 1993;36(1):70-3.
The diagnosis of capsular retraction of the hip is based on measurement of the capacity of the joint cavity on arthrography: it is reduced by at least 25% (normally 15 ml +/- 2 ml). The opaque area is only visible reduced in the more severe forms with a capacity of 5 ml or less. The arthrographic image is therefore not the key to the diagnosis. The major clinical sign is restriction of joint movement, especially in abduction and rotation. Secondary, "surgical" capsular retraction of the hip is the most common form. It is associated with synovial chondromatosis in more than one half of cases. The mean capacity is 6.8 ml (range: 0 to 12 ml). Irreducible flexion deformity and limitation of movement are of variable severity. Capsulectomy must be combined with joint debridement (systematically including the depth of the socket). "Medical" capsular retraction of the hip is the rarest form. It may be either idiopathic or secondary to diabetes or chronic barbiturate abuse. It is subacute and resolves within several months to two years. Fluoroscopic intra-articular injection of corticosteroids, repeated as required by pain, constitutes the best treatment.
关节腔容量至少减少25%（正常为15毫升±2毫升）。只有在关节腔容量为5毫升或更少的更严重病例中，不透光区域才明显减小。因此，关节造影图像并非诊断的关键。主要临床体征是关节活动受限，尤其是外展和旋转活动。继发性“手术性”髋关节囊挛缩是最常见的类型。在超过一半的病例中，它与滑膜软骨瘤病相关。平均关节腔容量为6.8毫升（范围：0至12毫升）。不可复位的屈曲畸形和活动受限的严重程度各不相同。囊切除术必须与关节清创术相结合（通常包括髋臼深部）。“医源性”髋关节囊挛缩是最罕见的类型。它可能是特发性的，也可能继发于糖尿病或长期滥用巴比妥类药物。它呈亚急性，在数月至两年内可缓解。根据疼痛情况必要时重复进行的透视引导下关节内注射皮质类固醇是最佳治疗方法。
