目的观察成年人髌股关节痛的Ｘ线改变。方法收集临床诊断为髌骨软骨软化或髌股关节骨性关节病的成年患者６５例，共计７２侧膝关节。摄屈膝３０侧位片和髌骨轴位片，进行Ｉｎｓａｌｌ－Ｓａｌｖａｔｉ和Ｍｅｒｃｈａｔ测量，并与对照组进行比较。结果两组髌骨高度的平均值比较，差异有显著性意义（ｔ检验，ｔ＝２．１５６，Ｐ＜０．０５）；两组髌骨指数平均值比较，差异有非常显著性意义（ｔ检验，ｔ＝０．６６８，Ｐ＜０．０１）；两组髌骨厚度平均值比较，差异有非常显著性意义（ｔ检验，ｔ＝４．８４２，Ｐ＜０．０１）；两组髌股协调角平均值比较，差异有非常显著性意义（ｔ检验，ｔ＝３．２５１，Ｐ＜０．０１）；两组髌股指数平均值比较，差异有非常显著性意义（ｔ检验，ｔ＝３．８０５，Ｐ＜０．０１）。５１侧髌骨Ｗｉｂｅｒｇ分型为稳定性较差的Ⅲ型。有４２侧膝关节有１～５种髌骨不稳定的Ｘ线其它旁证。结论成年髌股关节痛患者的髌股对线、对位、髌骨稳定性、髌骨运动轨迹均有异常。因此，对髌股关节痛患者要查明原因，针对病因进行治疗。Ｍｅｒｏｈａｔ位Ｘ线图像对髌股关节疾病的诊断、手术病例和手术方式的选择，以及对手术成败原因的评价具有重要意义。 Objective To observe the X-ray changes of patellofemoral joint pain in adults. Methods Totally 65 adult patients with clinical diagnosis of chondromalacia patellae or patellofemoral joint osteoarthrosis were enrolled. A total of 72 knees were collected. Thirty knee lateral and patellar axial radiographs were performed, and Insall-Salvati and Merchat measurements were performed and compared with controls. Results The mean patellar height of the two groups had significant difference (t-test, t = 2.156, P <0.05). There was significant difference between the mean patella index of the two groups (t test, t = 0.668, P <0.01). There was significant difference between the two groups in the mean patellar thickness (t test, t = 4.842, P <0.01) There was significant difference between the two groups (t-test, t = 3.251, P <0.01). There was significant difference between the two groups in the mean of patellofemoral index (t-test, t = 3). 805, P <0.01). 51 lateral patellar Wiberg classification of less stable type Ⅲ. There are 42 side of the knee has 1 to 5 patellar instability X-ray other circumstantial evidence. Conclusion The patellofemoral plexus of adult patients with patellofemoral joint pain have abnormality of alignment, alignment, stability of patella and patellar movement. Therefore, the patellofemoral joint pain patients to identify the cause, for the cause of treatment. Merohat’s X-ray image is of great significance for the diagnosis of patellofemoral joint diseases, the selection of surgical cases and surgical procedures, as well as the evaluation of the causes of success or failure of surgery.