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成人髋关节疼痛的影像学评价

Authors
Cecilia Matilda Jude, MD
Shahla Modarresi, MD
Section Editors
Robert H Shmerling, MD
Karl B Fields, MD
Deputy Editor
Monica Ramirez Curtis, MD, MPH
Translators
孟悛非, 教授

引言

髋关节是人体一个稳定的和主要的承重关节，活动度高。在成人和儿童中，髋关节疼痛具有不同的病因。成人的髋关节疼痛可能由关节内病变造成，如缺血性坏死(avascular necrosis, AVN)、关节炎、游离体、盂唇撕裂；关节周围病理病变如肌腱炎、滑囊炎；或者由关节外病变如腰椎病变、骶髂关节病变和神经卡压综合征的牵涉痛引起。

本专题将总结用于评价成人髋关节疼痛的影像学方法，以及不同临床情况下具体检查方法的适用性。选择影像学检查前，询问病史及体格检查对建立鉴别诊断来说是必要的；用于评价骨及关节疼痛的影像学检查的一般性综述，以及用于儿童髋关节疼痛评价的影像学方法参见其他专题。 (参见“成人髋痛的评估”和“关节疼痛的影像学评估”和“婴儿、儿童和青少年髋关节的放射学评估”)

影像学检查方法

可用于评价髋关节的检查方法包括：

X线平片 — X线平片是任何原因引起的髋关节疼痛的初始评价，包括创伤、运动损伤、疑似AVN、关节炎、髋关节成形术、感染、发育不良和肿瘤[1]。X线平片也可确定牵涉性髋关节疼痛的原因，如骶髂关节炎。X线平片可能无法发现或准确显示一些髋关节骨折，以及与早期AVN或早期骨髓炎有关的骨髓水肿。

计算机断层扫描 — 计算机断层扫描(computerized tomography, CT)在创伤时的术前规划，以及评估肿瘤和引导肿瘤经皮穿刺活检最有帮助。

                                     

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Literature review current through: 2017-06 . | This topic last updated: 2017-06-13.
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