摘要
目的基于MRI探讨膝骨关节炎病人软骨损伤、半月板损伤、骨髓水肿及滑膜炎等常见损伤与疼痛程度的相关性。方法纳入2018年9月至2021年1月于望京医院骨关节二科就诊的膝骨关节炎病人150例,近期均无外伤、疼痛明显加重,均行MRI检查。采用西安大略和麦克马斯特大学(Western Ontario and McMaster Universities,WOMAC)骨关节炎指数中的疼痛评分表示病人膝关节疼痛程度,与MRI检查中的各项关节损伤评分进行相关性分析,从而探讨膝骨关节炎病人疼痛的相关因素。结果150例(100%)膝骨关节炎病人均有软骨损伤MRI表现,136例(90.67%)有骨髓水肿影像学表现及明显阳性体征,65例(43.33%)MRI示有半月板损伤但仅有14例病人有相应临床表现,50例病人(33.33%)有滑膜炎影像学表现及临床症状。研究表明软骨损伤、骨髓水肿与关节疼痛呈中度相关(ρ=0.592、ρ=0.695),半月板损伤、滑膜炎与关节疼痛呈低度相关(ρ=0.388、ρ=0.452)。结论膝骨关节炎病人的疼痛主要由软骨损伤、骨髓水肿导致,半月板损伤、滑膜炎亦与关节疼痛具有一定联系,临床工作者应合理使用MRI检查,明确膝关节疼痛病因,制定科学合理的治疗计划。
Objective To investigate the related factors affecting the pain of knee osteoarthritis patients based on MRI technology.Methods A total of 150 patients with knee osteoarthritis who had no recent trauma,and all underwent MRI examination at the Department of Orthopaedics of Wangjing Hospital from September 2018 to January 2021 were included.The degree of knee pain was evaluated by the pain score of Western Ontario and McMaster Universities(WOMAC).The related factors of pain in patients with knee osteoarthritis were explored by analyzing the correlation between the joint injury score in MRI and the pain score of knee.Results 150(100%)patients with knee osteoarthritis had MRI findings of cartilage damage,136(90.67%)patients had bone marrow edema imaging findings and significant positive signs,and 65(43.33%)patients showed meniscus injury on MRI but only 14 patients had corresponding clinical manifestations,and no obvious synovitis.50(33.33%)patients showed the MRI findings of synovitis.Statistical studies indicate that cartilage injury,bone marrow edema and joint pain were moderately related(ρ=0.592,ρ=0.695).The meniscus injury score and synovitis were lowly correlated with joint pain(ρ=0.388,ρ=0.452).Conclusion The pain in knee osteoarthritis patients is mainly caused by cartilage injury and bone marrow edema.Meniscus injury and synovitis are also related to joint pain.Clinical workers should use MRI examination reasonably to determine the cause of knee joint pain,and make the scientific and reasonable treatment plan.
作者
肖龙文
胡海威
桑灏祺
陈玉柳
毕春强
桑志成
XIAO Long-wen;HU Hai-wei;SANG Hao-qi;CHEN Yu-liu;BI Chun-qiang;SANG Zhi-cheng(Beijing Fengsheng Special Hospital of Traditional Medical Traumatology and Orthopaedics,Beijing 100033,China;Beijing University of Chinese Medicine,Beijing 100029,China;The Second Department of Orthopaedics,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China;The Second Department of Orthopaedics,South Campus of Guanganmen Hospital of China Academy of Chinese Medical Sciences,Beijing 102699,China)
出处
《骨科》
CAS
2021年第4期334-338,共5页
ORTHOPAEDICS
基金
中国中医科学院广安门医院南区院级科研基金(Y2019-08)。
