肌骨超声在中老年退行性膝关节病变的临床应用价值

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摘要目的探讨肌骨超声对中老年退行性膝关节病变的临床诊断价值。方法选取我院临床诊断为退行性膝关节病变患者60例(87个膝关节)，男32例，女28例；年龄55~78岁，平均(61.5±6.5)岁。所有患者患侧膝关节均行US、MRI检查及关节镜手术。通过膝关节US和MRI检查结果与关节镜手术后诊断进行比较，分析肌骨超声(ultrasound，US)诊断退行性膝关节病变的临床价值。结果肌骨US可以清晰地显示关节软骨病变、滑膜增厚及关节积液，并且可以观察增生滑膜内的血流信号丰富程度，其与MRI的诊断符合率比较，差异无统计学意义(P＞0.05)。但是对于诊断肌腱、半月板及韧带的损伤，MRI明显优于肌骨US，二者比较差异有统计学意义(P＜0.05)。结论肌骨US对退行性膝关节早期病变的诊断价值与MRI相同，可作为中老年膝关节病的常规检查，值得临床推广应用。

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	刘洁
	刘安
	陈世强

关键词 ：肌骨超声, 膝关节, 退行性病变

Abstract：Objective To investigate the clinical diagnostic value of musculoskeletal ultrasound in the diagnosis of senile degenerative knee joint lesions.Methods Sixty patients (87 knees) with degenerative knee arthropathy were selected.All knees were examined by musculoskeletal ultrasound，MRI and arthroscopic surgery.The clinical value of musculoskeletal ultrasound in the diagnosis of degenerative knee joint disease was analyzed by comparing the results of ultrasound and MRI examination of knee joint with the diagnosis after arthroscopic surgery.Results Musculoskeletal ultrasound could clearly show articular cartilage lesions，synovial thickening and joint effusion，and the abundance of blood flow signals in proliferative synovium.There was no significant difference between ultrasound and MRI in diagnostic coincidence rate (P＞0.05).However，for the diagnosis of tendon，meniscus and ligament injuries，MRI was significantly better than musculoskeletal ultrasound，the difference was statistically significant (P＜0.05).Conclusion The diagnostic value of musculoskeletal ultrasound for early degenerative knee joint lesions is the same as that of MRI.It canbe used as a routine examination of knee joint diseases in middleaged and elderly people，and is worthy of clinical application.

Key words： musculoskeletal ultrasound knee joints degenerative diseases

基金资助:海南省重点研发计划(ZDYF2016106)

作者简介: 刘洁(1970－ )，男，主治医师，海南省人民医院，570311。

引用本文:

刘洁，刘安，陈世强. 肌骨超声在中老年退行性膝关节病变的临床应用价值[J]. 实用骨科杂志, 2019, 25(4): 310-312.
Liu Jie，Liu An，Chen Shiqiang. Musculoskeletal Ultrasound in The Diagnosis of Senile Degenerative Knee Joint Lesions. sygkzz, 2019, 25(4): 310-312.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2019/V25/I4/310

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