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目的探讨骶髂关节生理性退变CT表现,以提高与病理改变间的鉴别诊断水平。方法对无明确腰骶部临床症状,且扫描范围包括骶髂关节的375例患者的CT资料进行回顾性分析,应用χ2检验统计分析各种退行性改变征象在不同年龄段、不同性别间的发生几率。结果关节间隙狭窄少见,发生几率不随年龄的增长而增加,各年龄段男女间差异均无统计学意义(P值均>0.05)。骨赘均发生在30岁以上,随年龄的增长发生几率逐渐增加,各年龄段同龄的女性发生几率高于男性,30~39岁组、40~49岁组,差异有统计学意义(P<0.05)。关节面硬化男性少见,60岁以上发生几率最高,仅为23%;女性关节面硬化发生率高,并呈现两个高峰年龄段,分别为20~29岁70%,60岁以上68%;各年龄段同龄的女性发生几率高于男性,差异均有统计学意义(P值均<0.05)。关节面下小囊状改变,男性、女性高发年龄段均为60岁以上,各年龄段女性发生几率高于男性,10~19岁组差异有统计学意义(P<0.05),余年龄段差异均无统计学意义(P值均>0.05)。关节面骨侵蚀均发生于60岁以上,女性发生几率(5/40,13%)高于男性(3/40,8%),差异无统计学意义(P>0.05)。结论关节间隙狭窄不能单独作为退变征象。女性20~29岁关节面硬化出现高峰可能为妊娠所致。关节面下小囊状改变见于正常骶髂关节。年轻患者出现骨侵蚀应作为病理性改变。男性退变征象单一,以关节周围骨赘形成为主;同龄女性退变程度较男性重,骨赘、关节面硬化、关节面下小囊状改变多种退变征象可同时出现。
Objective To investigate the physiological manifestations of sacroiliac joint degeneration in order to improve the differential diagnosis with pathological changes. Methods lumbosacral no clear clinical symptoms and CT scan range include information on 375 cases of patients with sacroiliac joint retrospective analysis, the application of statistical analysis χ2 test various signs of degenerative changes at different ages, different genders occurs between probability. Results The joint space stenosis was uncommon and the incidence did not increase with age. There was no significant difference between men and women in all age groups (P> 0.05). Osteophyte occurred in more than 30 years of age, with the increase of the probability of increasing the age of women of all ages with the same age were higher than men, 30 to 39 years old group, 40 to 49 years old group, the difference was statistically significant (P < 0.05). Articular sclerosis is rare in men, with the highest incidence of over 60 years old, only 23%. The incidence of articular sclerosis in women is high, with two peak age groups, 70% of 20-29 years old and 68% of those over 60 years old respectively. The incidence of women of the same age group was higher than that of men, the differences were statistically significant (P <0.05). Small capsular changes in the articular surface, male and female high incidence of age were 60 years of age, the incidence of women of all ages higher than men, 10 to 19 years old group difference was statistically significant (P <0.05), the remaining age difference No statistical significance (P> 0.05). Arthroscopic bone erosion occurred in patients over the age of 60, the incidence of women (5 / 40,13%) than men (3 / 40,8%), the difference was not statistically significant (P> 0.05). Conclusions Joint stenosis can not be used alone as a degenerative sign. 20 to 29 years old female face sclerosis peak may be caused by pregnancy. Small saccular changes seen in the articular surface of the normal sacroiliac joint. Bone erosion in younger patients should be pathologically altered. Male degenerative signs of a single, mainly to the formation of osteophytes around the joints; the same age women degenerated more than men, osteophytes, articular surface sclerosis, small articular surface changes in a variety of small cystic signs can occur simultaneously.