Konermann W, Gruber G
Orthopädische Klinik, Fakultät für Klinische Medizin Mannheim, Universität Heidelberg.
Orthopade. 1997 Oct;26(10):830-7. doi: 10.1007/s001320050162.
The efficiency of ultrasound was tested in septic arthritis. A total of 259 children with hip pain, septic arthritis (n = 14), transient synovitis (n = 120), juvenile rheumatoid arthritis (n = 12), Legg-Calvé-Perthes disease (n = 92) and slipped capital femoral epiphysis (n = 21) were examined by ultrasound. By using the standard planes described by the DEGUM, it is possible to analyze the joint capsule, the surface of the femoral head and the periarticular structures. In cases with synovitis or joint effusion, capsular distention can be diagnosed by ultrasound. This distention is typical in septic arthritis, transient synovitis, juvenile rheumatoid arthritis, and in the onset phase of Perthes disease. Because capsular distention and osseous abnormalities in the various diseases are similar differentiation is not possible. Therefore, ultrasound cannot distinguish between septic and non-specific arthritis; capsular distention is a non-specific ultrasound sign. Immediate diagnostic puncture is necessary if septic arthritis is suspected (possible by ultrasound control). In cases with both capsular distention and osseous abnormalities, ultrasound usually allows differentiation between slipped capital femoral epiphysis/Perthes disease and septic/non-specific arthritis.
在化脓性关节炎中对超声的效能进行了测试。共有259例髋关节疼痛的儿童接受了超声检查，其中包括化脓性关节炎（n = 14）、暂时性滑膜炎（n = 120）、幼年类风湿关节炎（n = 12）、Legg-Calvé-Perthes病（n = 92）和股骨头骨骺滑脱（n = 21）。通过使用由DEGUM描述的标准平面，可以分析关节囊、股骨头表面和关节周围结构。在滑膜炎或关节积液的病例中，超声可诊断出关节囊扩张。这种扩张在化脓性关节炎、暂时性滑膜炎、幼年类风湿关节炎以及Perthes病的发病阶段都很典型。由于各种疾病中的关节囊扩张和骨质异常相似，因此无法进行鉴别。所以，超声无法区分化脓性关节炎和非特异性关节炎；关节囊扩张是一种非特异性超声征象。如果怀疑是化脓性关节炎（可通过超声引导），则需要立即进行诊断性穿刺。在既有关节囊扩张又有骨质异常的病例中，超声通常能够区分股骨头骨骺滑脱/Perthes病与化脓性/非特异性关节炎。
