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剥脱性骨软骨炎

最后审阅: 1 Nov 2024
最后更新: 31 Mar 2022

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 活动时疼痛加重
  • 疼痛部位:膝关节屈曲至 90º 时的膝关节前内侧面
  • 疼痛部位:肘关节外侧面
  • 疼痛部位:背屈踝关节的后内侧面或跖屈踝关节的前外侧面
  • 出现渗出
  • 关节交锁
  • 关节粘滞感
  • 关节活动度降低
完整详情

其他诊断因素

  • 累及膝关节,年龄 10-20 岁
  • 累及肘关节,年龄为 11-21 岁
  • 距骨受累,十几岁至四十岁
  • 有累及膝关节或肘关节的外伤史
  • 累及膝关节或距骨的剥脱性骨软骨炎中的防痛步态
  • 累及膝关节的剥脱性骨软骨炎中的外旋步态
  • 缓解因素:非甾体抗炎药 (NASID)、休息、冰敷和抬升
  • 捻发音
  • 威尔逊氏试验
  • 四头肌萎缩
完整详情

危险因素

  • 反复投掷/外翻应力
  • 体操/上肢承重
  • 踝关节扭伤/不稳定
  • 竞技运动
  • 家族史
完整详情

诊断性检查

首要检查

  • 膝关节 X 线片
  • 踝关节 X 线片
  • 下肢全长 X 线片
  • 肘关节 X 线片
完整详情

需考虑的检查

  • CT
  • 核磁共振成像 (MRI)
  • MR 关节 X 线摄影
  • 诊断性关节镜检查
完整详情

治疗流程

急症处理

膝关节

肘关节

踝关节(距骨)

撰稿人

作者

Henry G. Chambers, MD

Professor of Clinical Orthopedic Surgery

University of California, San Diego

Rady Children’s Hospital

San Diego

CA

利益声明

HGC is an author of a number of references cited in this topic.

鸣谢

Dr Henry G. Chambers would like to gratefully acknowledge Dr James L. Carey, Dr Jon Divine, Dr Michael Nett, and Dr Cedric Ortiguera, the previous contributors to this topic.

利益声明

JLC is an author of a number of references cited in this topic. JD, MN, and CO declared that they had no competing interests.

同行评议者

James E. McGrory, MD

Orthopedic Surgeon

The Hughston Clinic PC

Columbus

GA

利益声明

JEM declares that he has no competing interests.

Nicola Maffulli, MD, MS, PhD, FRCS(Orth)

Centre Lead and Professor of Sports and Exercise Medicine

Consultant Trauma and Orthopaedic Surgeon

Barts and The London School of Medicine and Dentistry

Institute for Health Sciences Education

Centre for Sports and Exercise Medicine

Queen Mary University of London

Mile End Hospital

London

UK

利益声明

NM declares that he has no competing interests.

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