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标题: X3987:跛行，髋部疼痛，无外伤，无酗酒，无激素治疗史 [打印本页]

作者: liangshusheng 时间: 2008-4-19 21:30
标题: X3987:跛行，髋部疼痛，无外伤，无酗酒，无激素治疗史
女，43岁，跛行，髋部疼痛，无外伤，无酗酒，无激素治疗史，

[本贴已被 jiajie 于 2008-4-19 13:38:36 修改过]

作者: ducky807 时间: 2008-4-19 22:08
这是一个典型的扁平髋，股骨头变扁，密度增高，内可见低密度区，考虑股骨头缺血性坏死

作者: 358450m 时间: 2008-4-19 22:23
标题: 回复：x3987:跛行，髋部疼痛，无外伤，无酗酒，无激素治

以下是引用ducky807在2008-4-19 14:08:00的发言：[br]这是一个典型的扁平髋，股骨头变扁，密度增高，内可见低密度区，考虑股骨头缺血性坏死

作者: gjj6818 时间: 2008-4-19 23:16
标题: 回复：x3987:跛行，髋部疼痛，无外伤，无酗酒，无激素治

以下是引用ducky807在2008-4-19 14:08:00的发言：[br]这是一个典型的扁平髋，股骨头变扁，密度增高，内可见低密度区，考虑股骨头缺血性坏死

作者: xiazhuzhu 时间: 2008-4-19 23:21
标题: 回复：x3987:跛行，髋部疼痛，无外伤，无酗酒，无激素治

以下是引用gjj6818在2008-4-19 15:16:00的发言：[br][quote]以下是引用ducky807在2008-4-19 14:08:00的发言：[br]这是一个典型的扁平髋，股骨头变扁，密度增高，内可见低密度区，考虑股骨头缺血性坏死

[br][/quote]

作者: wjyd 时间: 2008-4-19 23:36
骨骺脱位后遗改变

作者: jiangjing 时间: 2008-4-19 23:39
这是一个典型的扁平髋，股骨头变扁，密度增高，内可见低密度区，考虑股骨头缺血性坏死伴退行性病变或髋臼发育不良伴无菌坏死

作者: zxd20000315 时间: 2008-4-19 23:49
标题: 回复：x3987:跛行，髋部疼痛，无外伤，无酗酒，无激素治
典型的perthes病

作者: road31520012002 时间: 2008-4-20 00:02
标题: 回复：x3987:跛行，髋部疼痛，无外伤，无酗酒，无激素治

以下是引用jiangjing在2008-4-19 15:39:00的发言：[br]这是一个典型的扁平髋，股骨头变扁，密度增高，内可见低密度区，考虑股骨头缺血性坏死伴退行性病变或髋臼发育不良伴无菌坏死

作者: 麻醉一生 时间: 2008-4-20 01:03
这是一个典型的扁平髋，股骨头变扁，密度增高，内可见低密度区，考虑股骨头缺血性坏死

作者: 大漠孤雁 时间: 2008-4-20 01:08
首先考虑扁平髋.

作者: menghaitian 时间: 2008-4-20 01:23
考虑股骨头缺血性坏死

作者: liangshusheng 时间: 2008-4-20 01:23
髋臼发育不良性骨关节病伴股骨头缺血坏死？股骨头半脱位

作者: 寒月残冰 时间: 2008-4-20 01:27
右髂关节呈半脱位，股骨头塌陷变扁、肥大并向外上方移位，股骨头及髂臼均见大片状高密度阴影，股骨颈粗短。

没有提供患者跛行时间，若时间从儿童时期就有，多考虑为股骨头骨骺缺血坏死晚期。若无既往病史，则不考虑为股骨头缺血坏死，此病例不具备成人股骨头缺血坏死影像特征，须进一步检查。

作者: 黑白光影 时间: 2008-4-20 03:45
扁平髋。

作者: yangyudong333 时间: 2008-4-20 05:08
这是一个典型的扁平髋，股骨头变扁，密度增高，内可见低密度区，考虑股骨头缺血性坏死

作者: 形影不离 时间: 2008-4-20 05:13
这是一个典型的扁平髋，股骨头变扁，密度增高，内可见低密度区，考虑股骨头缺血性坏死。

作者: 宇宙CT 时间: 2008-4-20 05:13
这是一个典型的扁平髋，股骨头变扁，密度增高，内可见低密度区，考虑股骨头缺血性坏死伴退行性病变或髋臼发育不良伴无菌坏死

作者: liuyue 时间: 2008-4-20 07:01
典型的扁平髋

作者: kaisar 时间: 2008-4-20 10:55
这是一个典型的扁平髋，股骨头变扁，密度增高，内可见低密度区，考虑股骨头缺血性坏死

作者: qc80012345 时间: 2008-4-20 15:16
髋臼发育不良性骨关节病伴股骨头半脱位。

作者: lzplmx 时间: 2008-4-20 17:57
考虑股骨头缺血性坏死

作者: 余辉 时间: 2008-4-20 18:46
标题: 回复：x3987:跛行，髋部疼痛，无外伤，无酗酒，无激素治

以下是引用jiangjing在2008-4-19 15:39:00的发言：[br]这是一个典型的扁平髋，股骨头变扁，密度增高，内可见低密度区，考虑股骨头缺血性坏死伴退行性病变或髋臼发育不良伴无菌坏死

作者: 杀毒软件 时间: 2008-4-20 20:10
标题: 回复：x3987:跛行，髋部疼痛，无外伤，无酗酒，无激素治

以下是引用jiangjing在2008-4-19 15:39:00的发言：[br]这是一个典型的扁平髋，股骨头变扁，密度增高，内可见低密度区，考虑股骨头缺血性坏死伴退行性病变或髋臼发育不良伴无菌坏死

支持

作者: 王2008 时间: 2008-4-20 22:55
以下是引用jiangjing在2008-4-19 15:39:00的发言：
这是一个典型的扁平髋，股骨头变扁，密度增高，内可见低密度区，考虑股骨头缺血性坏死伴退行性病变或髋臼发育不良伴无菌坏死

支持

作者: 有风的日子 时间: 2008-4-20 23:31
answer for yxwsd:

[center]legg-calvé-perthes syndrome[/center]

legg-calvé-perthes syndrome is a degenerative disease of the hip joint, where a loss of bone mass leads to some degree of collapse of the hip joint, that is, to deformity of the ball of the femur and the surface of the hip socket. the disease is typically found in young children and small dogs, and it can lead to osteoarthritis in adults.

it is the idiopathic avascular osteonecrosis of the capital femoral epiphysis of the femoral head. it is caused by an interruption to the blood supply of the head of the femur close to the hip joint. it is equivalent to adult avascular necrosis.

it is also known as perthes disease, ischemic necrosis of the hip, coxa plana, osteochondritis and avascular necrosis of the femoral head, or legg-perthes disease or legg-calve-perthes disease (lcpd).

cause

the direct cause is a reduction in blood flow to the joint, though what causes this is unknown. it is thought that the artery of the ligamentum teres femoris closes too early, not allowing time for the medial circumflex femoral artery to take over. genetics does not appear to be a determining factor, though it may be involved. when the disease is genetic in origin, it typically runs along the male line. some evidence suggests that parental smoking may be a factor, though this is not yet proven, or more recently that a deficiency of some blood factors used to disperse blood clots may lead to blockages in the vessels supplying the joint, but that, too, has not been proven.

signs and symptoms

symptoms are hip or groin pain, exacerbated by hip/leg movement. there is a reduced range of motion at the hip joint and a painful or antalgic gait. there may be atrophy of thigh muscles from disuse and an inequality of leg length. in some cases, some activity can cause severe irritation or inflammation of the damaged area including standing, walking, running, kneeling, or stooping repeatedly for an extended period of time.

the first signs are complaints of soreness from the child, which are often dismissed as growing pains, and limping or other guarding of the joint, particularly when tired. the pain is usually in the hip, though can also be felt in the knee (so-called &#39；referred pain&#39；). in some cases, pain is felt in the unaffected hip and leg. this is due to the child favoring the injured side and placing the majority of the weight on the \"good\" leg. it is predominantly a disease of boys (around 4 in 5 cases). whereas perthes is generally diagnosed between 5 and 12 years of age, it has been diagnosed in children as young as infants. typically the disease is only seen in one hip, bilateral perthes is seen in about 8-10% of children diagnosed.

diagnosis

x-rays of the hip joint are absolutely necessary. a bone scan may be useful in helping determine the extent of the avascular changes. a hip aspiration may be performed if there is suspicion of a septic arthritis.

diagnosis is made predominantly by x-ray study, together with physical examination (mris have also been found useful for judging the extent of the deformity). sufferers typically have limited range of motion in their hip, particularly when rotating the joint.

treatment

the goal of treatment is to avoid severe degenerative arthritis. orthopedic assessment is crucial. younger children have a better prognosis than older children. currently, there are studies conducted on bisphosphonates[2] for treatment of perthes. analgesic medication may be given as necessary.

treatment has traditionally centered on removing pressure from the joint until the disease has run its course. options have included bed rest and traction (to separate the femur from the pelvis and reduce wear), often for several months or even years. plaster casts were also popular, again

作者: jinguoji 时间: 2008-4-21 01:18
股骨头变扁，密度增高，内可见低密度区，考虑股骨头缺血性坏死伴退行性病变或髋臼发育不良伴无菌坏死

作者: hexue 时间: 2008-4-21 02:44
标题: 回复：x3987:跛行，髋部疼痛，无外伤，无酗酒，无激素治
考虑股骨头缺血性坏死

作者: zhangkening 时间: 2008-4-21 05:30
我不支持扁平髋，髋臼那么深能是扁平髋吗？

作者: wy232326 时间: 2008-4-21 06:25
股骨头变扁，密度增高，内可见低密度区，考虑股骨头缺血性坏死伴退行性病变或髋臼发育不良伴无菌坏死支持

作者: dyqct 时间: 2008-4-22 01:07
标题: 回复：x3987:跛行，髋部疼痛，无外伤，无酗酒，无激素治

以下是引用ducky807在2008-4-19 14:08:00的发言：[br]这是一个典型的扁平髋，股骨头变扁，密度增高，内可见低密度区，考虑股骨头缺血性坏死

支持！建议加照侧位除外水平骶椎。

作者: shibing 时间: 2013-12-31 07:27
扁平髋

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