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背景:大骨节病(Kashin-Beck disease,KBD)是一种原因不明、以关节软骨和骺板软骨变性坏死为基本病变的地方性骨关节病。既往研究发现,几乎所有成人KBD患者均存在手部关节异常,手部关节的影像学改变特点是区分KBD和其他骨关节疾病的重要参考因素。目的:研究四川省阿坝州壤塘县藏族成人KBD患者手部X线片特征。方法:四川省阿坝州壤塘县120例藏族成人KBD患者为KBD组,选取年龄性别匹配的120位正常人作为对照组,均行双手前后位X线片检查,研究其影像学特点,测量KBD组及对照组右手近节和中节指骨指数。结果:KBD组120例,男42例,女78例;年龄为20～80岁,平均63.6岁。双手前后位X线片检查示方形骨端108例,喇叭状干骺端112例,腕骨拥挤113例,桡骨远端增粗及变短92例,指间关节半脱位57例,108例患者表现为关节间隙变窄、软骨下骨硬化及关节边缘骨赘增生等骨关节炎改变。KBD组男性患者及正常男性中指近节指骨指数分别为4.04及4.16(P=0.021),女性患者及正常女性分别为4.21及4.37(P=0.013)。结论:四川省阿坝州壤塘县藏族成人KBD患者手部X线片示方形骨端、喇叭状干骺端、腕骨拥挤、桡骨远端增粗变短、指间关节半脱位及骨关节炎改变。男、女患者近节指骨指数小于正常人群。
BACKGROUND: Kashin-Beck disease (KBD) is a endemic osteoarthritis of unknown origin with degeneration and necrosis of articular cartilage and epiphyseal plate cartilage. Previous studies have found that hand-joint abnormalities exist in almost all adult KBD patients. The imaging features of the hand joints are important reference factors to distinguish KBD from other bone-joint diseases. Objective: To study the X-ray features of Tibetan adult KBD patients in Rangtang County, Aba Prefecture, Sichuan Province. Methods: One hundred and twenty Tibetan adult KBD patients in Rangtang County of Aba Prefecture of Sichuan Province were KBD patients. 120 normal subjects of age and gender matched were selected as control group. Both anterior and posterior X-ray examination of both hands were performed to study the imaging features of KBD Group and control group, right hand proximal and middle phalanx index. Results: KBD group of 120 cases, 42 males and 78 females; aged 20 to 80 years, mean 63.6 years. X-ray examination of anterior and posterior hands showed 108 cases of square bone, 112 trumpet-shaped metaphysis, 113 cases of carpal tunnel congestion, thickening and shortening of the distal radius in 92 cases, interphalangeal subluxation in 57 cases and 108 cases For joint narrowing, subchondral bone sclerosis and osteoarthritis and other joint edge of osteoarthritis changes. The proximal phalangeal index of the middle-finger and middle-finger of the KBD group were 4.04 and 4.16, respectively (P = 0.021). The female and normal women were 4.21 and 4.37 respectively (P = 0.013). Conclusion: The X-ray films of square adult KBD patients in adult Zangtang County, Aba Prefecture, Sichuan Province showed that the radius of the square bone, the trumpet shaped metaphysis, crowded carpal bones, the thickening of the distal radius, the change of the interphalangeal subluxation and the osteoarthritis . Male and female patients recent phalanx index was smaller than the normal population.