Progression in Avascular Necrosis of Femoral Head: Roentgenographic Study on Staging of Disease

股骨頭缺血性壞死系指股骨頭軟骨下骨壞死。當骨之再生修補能力比不上壞死速時，股骨頭終將崩塌並造成髖臼關節損壞。從1985年1月至1989年7月，本院有226位因股骨頭缺血性壞死而住院治療的病人，一共是318個髖關節。其病因包括原發性（佔37%）、酒精中毒性（佔34%）、長期服用類固醇（佔14%）、髖關節骨折或脫臼（佔14%）及潛水夫病（佔1.8%）。34位病人（45髖關節）曾接受系列之放射線追蹤檢查，追蹤的時間從症狀剛開始或開始前，到該髖關節接受治療或截至1989年7月止。我們選擇Enneking的六個分期，發現大多數病人（61%）在第二或第三期時，有疼痛的症狀出現。每惡化一期需時8.1個月，類在不同病因的組別間並無顯著的差異，此外對側髖關節有無接受關節整現術亦無顯著之影響。兩側股骨頭皆壞死的，在初診病人中佔35%，半年後達47%，二年後增加至65%，因此雖然診斷股骨頭壞死的放射線檢查還包括局部放射線檢法、同位素掃描、電腦斷層掃描及核磁共振儀等更靈敏的方法，但是對於長期一系列追蹤檢查，甚至篩選檢查，仍以普放射線檢查為簡單、便宜、快速方便。

關鍵字

無資料

並列摘要

In order to investigate the progression of avascular necrosis of femoral head, we retrospectively studied 318 hips of 226 cases who were seen from Jan. 1985 to July 1989 due to this disease. The etiologies included idioipathy (37%), alcoholism (34%), long term steroid therapy (14%), trauma (11%) and caisson disease (1.8%). The stage of the disease on patient’s arrival varied from Enneking’s stage I to VI, but half of the hips were beyond stage V and VI. Forty-five hips of 34 cases had sequential follow-up with plain roentgenography before or just after the symptom appeared till the hips were operated or till July 1989 if not operated. The majority of patients experienced onset of pain at stage II or III. The duration of progression for one worse stage varied from one month to three years and the mean duration was 8.1 months. There was no significant difference in groups of different etiologies, nor between hips of natural progression and those hips whose contralateral side receiving arthroplasty. Bilateral hip involvement was 35% on arrival and 65% after 2 years of follow-up by plain films. Plain roentgenography, although less sensitive than other examinations such as tomography, bone scan, computerized tomography and magnetic resonance image, it is cheap, convenient and quick for sequential follow-up even for screening examination in silent hips with high risk.

並列關鍵字

avascular necrosis ； osteonecrosis ； aseptic necrosis ； femoral head

國際替代計量

Progression in Avascular Necrosis of Femoral Head: Roentgenographic Study on Staging of Disease

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