Pistarini C, Carlevati S, Contardi A, Cannizzaro G
Divisione di Recupero e Rieducazione Funzionale, Fondazione Clinica del Lavoro, Montescano, Pavia.
Recenti Prog Med. 1995 Dec;86(12):483-8.
To assess the role of the ultrasonic imaging evaluation of articular lesions suspected to be the initial presentation of heterotopic ossifications (HO), 59 consecutive injured patients were studied. 32 out of 59 patients showed clinical signs of local inflammation in one of the articular sites of the upper or lower limbs, sonographic scans proved to be diagnostic of HO in 7 out of those 32 patients before their radiographic findings. Serial sonographic examinations were performed utilizing a 7.5 MegaHertz transducer probe for 2 months. The imaging abnormalities were correlated with biochemical levels of serum alkaline phosphatase, modifications of radiographic features and bone 99nTC scintigraphy. Scintigraphy revealed to have a high sensitivity but a low specificity for the diagnosis of HO. Also the serum levels of alkaline phosphatase were not a sensitive indicator of early HO in our group of patients. Moreover serial sonographic scans confidently excluded the HO in the 25 patients with no initial signs of the disease without any false negative results. Thus, early sonographic assessment of patients, with spinal cord injury in which local signs of inflammation suggest initial HO formation, revealed to be superior to the other utilized technique for the diagnosis of HO and may be considered a valuable alternative in particular to evaluate the evolutive pattern of this disease.
为评估超声成像在疑似异位骨化（HO）初始表现的关节病变评估中的作用，对59例连续受伤患者进行了研究。59例患者中有32例在上肢或下肢的一个关节部位出现局部炎症的临床体征，在这32例患者中，超声扫描在其X线表现之前就诊断出7例HO。使用7.5兆赫兹换能器探头进行了为期2个月的系列超声检查。将成像异常与血清碱性磷酸酶的生化水平、X线特征的改变以及骨99nTC闪烁扫描进行了关联。闪烁扫描显示对HO诊断具有高敏感性但低特异性。在我们的患者组中，血清碱性磷酸酶水平也不是早期HO的敏感指标。此外，系列超声扫描可靠地排除了25例无疾病初始体征患者中的HO，没有任何假阴性结果。因此，对脊髓损伤且局部炎症体征提示初始HO形成的患者进行早期超声评估，显示出优于其他用于诊断HO的技术，尤其在评估该疾病的演变模式方面可能被视为一种有价值的替代方法。
