论文部分内容阅读
目的 探讨B超检查辅助诊断儿童髋关节滑膜嵌顿症的方法。方法 18例患儿中男11例 ,女 7例 ,年龄 4～ 12岁 ,平均 9岁 ,均为单髋病变 ,左 8例 ,右 10例。应用DiasonicSynergy彩色超声仪检查 ,探头频率 10MHz。髋关节中立位 ,探头置于患侧和正常侧髋关节的前方、大转子的上方以及髋关节的内下方分别观察A、B、C型皱襞 ,可见关节间隙内团状强回声。结果 18例中 3例行走或下蹲时出现弹响 ,疼痛和典型体征随即消失 ,双下肢等长 ,行走自如 ;6例腰麻下手法复位 ,听到或感到弹响后关节活动自如 ;6例手法复位失败 ,行患肢皮牵引 ,适当应用抗生素 ,辅助微波理疗 ,骨盆倾斜逐渐消失 ,双下肢逐渐恢复等长而治愈 ;3例尚无明显效果 ,经手术治疗 ,症状体征消失 ,关节积液作细菌培养未见细菌生长 ,切除的滑膜组织病理检查报告为慢性非特异性炎症。B超复查 ,关节间隙团状回声消失。 18髋B超可见髋关节间隙增宽 ,内见液性暗区 ,深约 8～ 13mm不等 ,关节腔可探测团状强回声 ,内部回声不均匀。正常侧髋关节间隙 3～ 5mm ,腔内无团状回声。A型皱襞致病 4例、B型 2例、C型 12例 ,分别占 2 2 .2 % (4/ 18)、11.1% (2 / 18)和 6 6 .7% (12 / 18)。B超发现 1例C型皱襞嵌顿病例 ,保守治疗无效 ,经手术治疗痊愈并被证实。结论
Objective To investigate the method of B-ultrasound in the diagnosis of synovial incarceration in children. Methods 18 cases of children, 11 males and 7 females, aged 4 to 12 years, mean 9 years old, all single hip disease, left 8 cases, right 10 cases. Application DiasonicSynergy color ultrasound examination, probe frequency 10MHz. Hip neutral position, the probe placed in front of the ipsilateral and normal hip, the greater trochanter and the bottom of the hip were observed under the A, B, C-type folds, visible intra-articular mass echo strong echo. Results In 3 of 18 patients, snapping occurred when walking or squatting, and the pain and typical signs disappeared immediately. The lower extremities were equiaxed and walking freely. Six patients underwent reduction in the spinal anesthesia, and the joints were comfortable after they heard or felt snapping. Cases of hand reset failure, the line of skin traction, the appropriate application of antibiotics, microwave assisted physiotherapy, pelvic tilt gradually disappear, both lower extremities gradually recovering and healing; 3 no significant effect, after surgery, symptoms and signs disappeared, Bacterial growth was not observed for bacterial growth, and excised synovial tissue pathology was reported as chronic nonspecific inflammation. B-ultrasound, the disappearance of the intrastromal cystic echo. 18 hip B-wide hip space can be seen widening, see the liquid dark area, depth of about 8 ~ 13mm, the articular cavity can detect massive echo, the internal echo uneven. Normal hip joint space 3 ~ 5mm, intracavitary echo-free group. There were 4 cases of type A folds, 2 cases of type B and 12 cases of type C, accounting for 22.2% (4/18), 11.1% (2/18) and 6.6% (12/18) respectively. B-found in 1 case of C-type folds incarcerated cases, conservative treatment is invalid, recovered after surgery and was confirmed. in conclusion