多灶性骨坏死的发病规律

发布时间：2019-02-26 07:58

【摘要】：[目的]通过分析本中心收治的多灶发性骨坏死(multifocd osleonecrosis,MFON)病例的发病率、发病原因、诊断及治疗,研究如何实现对MFON的早期诊断,避免漏诊,并寻求最佳治疗方案。[方法]在2010年1月~2015年6月对本中心收治的存在MFON高危因素的骨坏死患者行影像学筛查,筛查中髋、膝关节均呈阳性者,不论其他关节是否存在临床症状,均加摄双肩、双踝MRI,必要时加摄双腕和双肘关节;对有皮质类固醇使用史或酗酒史偶尔查出肩、踝、腕、肘一个至数个关节坏死的患者,加摄髋、膝关节MRI及行其他部位的影像学检查。通过筛查,明确MFON诊断。[结果]2010年1月~2015年6月,本中心共收治骨坏死患者1 507例,入院诊断MFON仅48例,占3.1%,对入院未诊断MFON但存在高危因素的102例患者行影像学筛查,增加诊断MFON 31例,该时间段收治骨坏死患者MFON诊断率上升为5.2%。[结论]对有高危因素的骨坏死患者,应警惕MFON的存在,必要时增加其他关节的影像学筛查,以期实现MFON的早诊断、早治疗。
[Abstract]:[objective] to analyze the incidence, pathogenesis, diagnosis and treatment of multiple focal osteonecrosis (multifocd osleonecrosis,MFON) cases in our hospital, and to study how to realize the early diagnosis of MFON, avoid missed diagnosis and seek the best treatment scheme. [methods] from January 2010 to June 2015, the patients with osteonecrosis who had high risk factors of MFON were screened by imaging in our center. The patients with positive hip and knee joint were screened, no matter whether the other joints had clinical symptoms or not, the patients with osteonecrosis who had high risk factors of osteonecrosis were screened with both shoulders. When necessary, double wrist and elbow joint should be taken by MRI, of both malleolus; Patients with a history of corticosteroid use or alcoholism occasionally identified shoulder, ankle, wrist, elbow necrosis in one to several joints, plus hip and knee MRI and other imaging examinations. The diagnosis of MFON was confirmed by screening. [results] from January 2010 to June 2015, 1 507 cases of osteonecrosis were admitted to our center, and only 48 cases (3.1%) of MFON were diagnosed in the hospital. Among them, 31 cases of MFON were diagnosed by imaging screening, but there were high risk factors in the patients who had not been diagnosed with osteonecrosis, and the diagnosis of osteonecrosis was increased in 31 cases (3.1%). The diagnostic rate of MFON in patients with osteonecrosis increased to 5.2%. [conclusion] for the patients with osteonecrosis with high risk factors, the existence of MFON should be vigilant, and if necessary, the imaging screening of other joints should be added in order to realize the early diagnosis and treatment of MFON.
【作者单位】：北京中日友好医院骨关节外科骨坏死与关节保留重建中心;
【基金】：国家自然科学基金面上项目(编号:81672236;81372013) 中日友好医院青年科技英才计划项目(编号:2004-QNYC-A-06)
【分类号】：R681

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