Ultrasonographic Findings in Hemiplegic Knees of Stroke Patients

中風病人雙側肢體呈現不對稱關節病變的現象已經在許多研究中被報告，而關節病變會加重運動功能喪失並且阻礙復健治療的進行。骨骼肌肉超音波對於軟組識和膝關節軟骨具有良好的診斷力。本篇研究主要是使用超音波來評估中風合併半身癱瘓病患的雙側膝關節軟組識及關節內軟骨的變化。59位中風病患及15位健康對照組，分別以骨骼肌肉超音波5-12MHz寬頻高解析度的探頭(HDI 1500, Advanced Technology Laboratories, Bothell, WA, USA)評估雙膝之影像變化。結果顯示臏骨上方液體囤積(suprapatellar effusion)以及臏骨肌腱炎(patellar tendonitis)是偏癱側膝關節的主要超音波變化，且與非偏癱側比較呈現有統計學上的差異。在危險因子之分析結果顯示，糖尿病是發生關節外病變的危險因子，而女性則是發生關節內病變的主要危險因子。臏骨上方液體囤積(suprapatellar effusion)和鵝足狀肌腱發炎(pes anserinus tendonitis)之變化與運動功能狀態(Brunnstrom stages)呈現有統計上的相關。然而，罹病時間長短和癱瘓側膝關節的超音波異常表現的發生率並沒有顯著相關。結論，超音波是可以當作評估中風患者膝關節軟組識病變的良好工具。

關鍵字

超音波；半身偏癱；膝關節；中風

並列摘要

Clinical and radiologic asymmetric arthritic differences between paralyzed and nonparalyzed limbs of stroke patients have been reported. Arthritic pathology aggravates motor dysfunction and compromises rehabilitation. Musculoskeletal ultrasonography plays an important role in showing soft tissue and the articular cartilage of the knee. Fifty-nine patients with either ischemic or hemorrhagic stroke-induced right or left hemiplegia were recruited to evaluate soft-tissue and intra-articular cartilage changes in hemiplegic knees of stroke patients using ultrasonography. An additional 15 subjects (30 knees) without knee disease or a history of knee trauma or surgery were used as controls. There were significant differences in suprapatellar effusion and patellar tendinitis between hemiplegic and nonhemiplegic knees. Suprapatellar effusion and pes anserinus tendinitis were correlated with Brunnstrom stage. The length of time since stroke onset was not significantly correlated with positive ultrasonographic findings in hemiplegic knees. In conclusion, ultrasonography is useful for detecting periarticular soft-tissue changes and intra-articular lesions in hemiplegic knees of stroke patients.

並列關鍵字

ultrasonography ； hemiplegia ； knee ； stroke

國際替代計量

Ultrasonographic Findings in Hemiplegic Knees of Stroke Patients

未授權

主題瀏覽