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目的对四川崇州市崇阳镇石埂村不明原因骨关节病的临床表现及影像学特点进行分析,为进一步研究奠定基础。方法对病区年龄≥3岁的116名村民进行流行病学调查、体格检查、髋、膝关节运动功能评定及摄X线片检查并对其进行量化评价。结果116名村民临床诊断不明原因骨关节病64例,患病率为55.2%;跛行17例,发生率26.6%,发病年龄主要集中在40岁以前。临床表现为髋或膝关节固定性疼痛,双侧痛明显多于单侧,局部发热、肿胀不明显。轻、中度疼痛占73.5%,劳动或活动时加重,不采取任何措施或休息后缓解。关节痛在较长时间内不影响其运动功能,晚期主要表现为髋关节运动功能障碍而跛行。体格检查:髋屈曲、内外旋活动受限。Harris评分:左髋86.5±17.1分,右髋86.3±17.2分;优良46例(72.8%),中差18例(28.2%)。HSS评分:左膝88.4±9.3分,右膝88.2±11.0分;优良61例(95.3%),中差3例(4.7%)。X线片主要表现为髋关节间隙狭窄,呈退行性改变、关节面硬化变形,其次为髋臼密度增高、扁平、变形、倾斜度增加,对股骨头包容不足,颈干角增大;膝关节主要为骨刺或骨桥形成,受累关节骨质疏松、关节面不平整、增厚、硬化变形及呈退行性改变。结论崇州不明原因骨关节病临床表现早期以双侧膝关节或膝关节伴髋关节固定性疼痛、晚期髋关节出现运动功能障碍为主,影像学改变主要为髋关节发生退行性改变,需进一步研究明确诊断。
Objective To analyze the clinical manifestations and imaging features of unexplained osteoarthrosis in Shijie village, Chongyang town, Chongzhou city, Sichuan Province, and lay the foundation for further research. Methods The epidemiological survey, physical examination, motor function of hip and knee were performed on 116 villagers aged ≥ 3 years old and examined by radiography and quantified. Results Sixty-six villagers with clinical diagnosis of unexplained osteoarthrosis were found with a prevalence of 55.2%. There were 17 cases with claudication, accounting for 26.6%. The age of onset was mainly before the age of 40 years. Clinical manifestations of hip or knee pain, bilateral pain was significantly more than unilateral, local fever, swelling was not obvious. 73.5% of patients with mild to moderate pain, exacerbated labor or activities, take no measures or ease after rest. Articular pain in a long time does not affect their motor function, the latter mainly for hip dysfunction and limp. Physical examination: hip flexion, internal and external rotation is limited. Harris score: 86.5 ± 17.1 left hip, 86.3 ± 17.2 right hip; excellent in 46 cases (72.8%), and poor in 18 cases (28.2%). HSS score: 88.4 ± 9.3 points on the left knee and 88.2 ± 11.0 points on the right knee; excellent in 61 cases (95.3%) and poor in 3 cases (4.7%). X-ray showed mainly hip narrowing, degenerative changes, articular surface hardening deformation, followed by increased acetabular density, flat, deformation, increased tilt, tolerance of the femoral head, neck angle increases; knee joint Mainly spur or bone bridge formation, affected joints osteoporosis, articular surface roughness, thickening, hardening and degenerative changes. Conclusions The clinical manifestations of unexplained osteoarthrosis in Chongzhou were mainly fixed pain of bilateral knee joint or knee with hip joint and motor dysfunction of the hip in the early stage. Radiographic changes mainly degenerated the hip joint and further study was needed Clear diagnosis.