Bellaiche L, Wybier M, Champsaur P
Service de Radiologie Ostèo-articulaire, Hôpital Lariboisière, Paris.
Ann Radiol (Paris). 1997;40(1):11-21.
Painful hip with normal X-rays (including false-lateral view of both hips) is the main indication for hip arthrography, searching for focal chondropathy. In the presence of moderate hip degenerative arthritis contrasting with increasing disability, a labrum lesion must be investigated. Such lesions are of two kinds, mainly degenerative (of the superior labrum) or post-traumatic (of the posterior labrum). Arthrography allows the diagnosis of cystic changes located in the acetabulum. It also allows the diagnosis and evaluation of the extent of synovial osteochondromatosis or villonodular synovitis. In three indications, computed tomographies must be added to plain arthrography: posterior labrum lesions, osteochondromatosis (looking for foreign bodies in the acetabular fossa) and cystic changes in the acetabulum (with density measurements). In all cases, a complete conventional radiological assessment must be available. Strict asepsis must be ensured. When osteochondromatosis is suspected, evaluation of articular capacity must be systematic.
X线平片(包括双髋假侧位片)正常但髋关节疼痛是髋关节造影的主要指征,用于寻找局灶性软骨病。在存在中度髋关节退行性关节炎且残疾程度不断加重的情况下,必须对盂唇损伤进行检查。此类损伤有两种,主要是退行性(上盂唇)或创伤后(后盂唇)。关节造影可诊断髋臼内的囊性改变。它还可诊断和评估滑膜骨软骨瘤病或绒毛结节性滑膜炎的范围。在三种情况下,必须在普通关节造影基础上加做计算机断层扫描:后盂唇损伤、骨软骨瘤病(寻找髋臼窝内的异物)以及髋臼囊性改变(进行密度测量)。在所有情况下,都必须有完整的传统放射学评估。必须确保严格无菌。当怀疑有骨软骨瘤病时,必须系统评估关节功能。