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
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
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
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
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
治疗流程
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.
鉴别诊断
- 骨软骨骨折
- 半月板断裂
- 化脓性关节炎
更多 鉴别诊断指南
- 剥脱性骨软骨炎：诊断和治疗
更多 指南
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