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目的探讨老年性骨质疏松并存早中期股骨头缺血性坏死在普通X光片上的诊断难点及鉴剐要点。方法回顾性分析15例X线平片有不同程度骨质疏松。经CT检查确诊合并早中期股骨头缺血性坏死的漏诊病例。结果15例X线片中,均有不同程度的骨质疏松,仅有7例显示股骨头骨质密度不均,或有囊性及硬化改变,占46.6%。CT检查均可见股骨头除不同程度的骨质疏松外,皮质下伴有数量不等、大小不等的囊性变。8例股骨头中央星芒状骨纹结构模糊.伴骨小梁不规则增粗致密;4例股骨头囊变周围可见不规则的条片状骨质硬化。讨论老年性骨质疏松与股骨头坏死经常并存。在早中期易疏忽后者的存在;因此,髋关节疼痛的患者,X线平片有骨质疏松时,还要注意发现其间有无囊性改变及硬化改变。再结合临床病史,及时做CT检查及MRI检查,尽量早期发现有无股骨头坏死的存在。
Objective To investigate the diagnosis and treatment of osteoporosis in senile osteoporosis in early and middle stages of avascular necrosis of femoral head. Methods Retrospective analysis of 15 cases of X-ray films with varying degrees of osteoporosis. The missed diagnosis of avascular necrosis of the femoral head in the early and mid-term was confirmed by CT. Results Fifteen cases had different degree of osteoporosis in osteoporosis. Only 7 cases showed uneven density of femoral head bone or cystic and sclerosis, accounting for 46.6%. CT examination can be seen in addition to different degrees of femoral head osteoporosis, the cortex with varying amounts, varying sizes of cystic degeneration. 8 cases of central star-shaped bone structure of the femur fuzzy fuzzy with trabecular irregular thickening dense; 4 cases of femoral head cystic irregular strip-like sclerosis. Discussion Senile osteoporosis and femoral head necrosis often co-exist. In the early and mid-easy to ignore the latter’s existence; therefore, patients with hip pain, X-ray films with osteoporosis, but also pay attention to find the presence of cystic changes and sclerosis changes. Combined with clinical history, timely CT examination and MRI examination, as early as possible to find the existence of avascular necrosis.