Lim-Dunham J E, Ben-Ami T E, Yousefzadeh D K
Department of Radiology, Wyler Children's Hospital, University of Chicago, Pritzker School of Medicine, IL 60637, USA.
Pediatr Radiol. 1995;25(7):556-9. doi: 10.1007/BF02015794.
Twelve children with suspected septic arthritis of the elbow were prospectively studied with plain-film radiography and ultrasound. Imaging data were correlated with clinical history and final diagnosis. Joint effusion was seen by sonography in six patients, four of whom underwent ultrasound-guided joint aspiration, confirming the diagnosis of septic arthritis in two patients and excluding it in two. Of nine patients whose plain films showed only soft tissue swelling, seven had one or more significant findings with sonography: joint effusion (without fat pad elevation on lateral plain films) in three patients, periosteal reaction in two, and epitrochlear mass in three. Sonography confirmed soft tissue swelling alone in two patients, thus excluding the diagnosis of septic arthritis and obviating unnecessary attempts at joint aspiration. Sonography of the elbow is an informative, easily performed examination, which is capable of showing both intra- and extra-articular abnormalities not apparent by plain radiography. Both the demonstration of pathologic changes and the failure to show joint fluid may affect clinical management.
对12名疑似肘部化脓性关节炎的儿童进行了X线平片和超声的前瞻性研究。影像数据与临床病史及最终诊断相关联。超声检查发现6例患者有关节积液，其中4例接受了超声引导下的关节穿刺，2例确诊为化脓性关节炎，2例排除该诊断。9例X线平片仅显示软组织肿胀的患者中，7例超声检查有一项或多项显著发现：3例有关节积液（X线平片外侧无脂肪垫抬高），2例有骨膜反应，3例有肱骨内上髁肿块。超声检查证实2例患者仅存在软组织肿胀，从而排除了化脓性关节炎的诊断，避免了不必要的关节穿刺尝试。肘部超声是一种信息丰富、操作简便的检查方法，能够显示X线平片上不明显的关节内和关节外异常。病理改变的显示和关节液未显示均可能影响临床处理。
