【双语病例】髋臼撞击综合征(FAI) – 影像PPT

【双语病例】髋臼撞击综合征(FAI) –影像PPT

1.髋臼盂唇撕裂.

True

False

2.髋关节骨折.

True

False

3.The hip is dislocated（髋关节脱位）.

True

False

4.股骨颈轮廓异常.

True

False

Angle Measurement

Measurements were performed on the axial oblique images.

5.What is being measured here?

Acetabular angle

Alpha angle

Beta angle

Center-edge angle

Wiberg angle

6.The measured angle is 58°. What is the unifying diagnosis?

Ankylosing spondylitis

强直性脊柱炎

Developmental dysplasia of the hip

发育性髋关节发育不良

Femoral acetabular impingement (FAI) – cam type

股骨髋臼撞击综合征（FAI）-凸轮型

FAI – pincer type

股骨髋臼撞击综合征（FAI）-钳夹型

Primary osteoarthritis of the hip

髋关节原发性骨关节病

答案：

True

The superior labral tear is seen best on coronal images

No fracture line is seen on these images

False

The hip is normally aligned.

True

An osseous “bump” is noted best on the axial oblique images.

Alpha angle

The alpha angle is being measured. The other angles listed are also important in assessing for hip anomalies

Femoral acetabular impingement (FAI) – cam type While there is osteoarthritis present, the best unifying diagnosis, given the osseous bump in the femoral neck and the alpha angle greater than 50°, would be cam-type

Findings

Axial oblique T1 and coronal proton density-weighted

fat-saturated images of the right hip show a tear of the superior, anterior labrum. The axial oblique image shows the contour abnormality of the femoral neck, with an osseous bump creating an abnormal convexity at the head/neck junction. There is also cartilage loss and subchondral cystic changes beginning over the lateral acetabulum.

右髋关节斜横断位T1WI及冠状位脂肪抑制质子加权像示髋臼前上方盂唇撕裂。斜横断位示股骨颈轮廓异常，骨性撞击致股骨头颈交界处异常突起。髋臼侧可见软骨磨损、软骨下囊性变。

The alpha angle, measured as shown, is 58° (normal less than 50°).

如图所示，alpha角测量值58°（正常值小于50°）。

Differential Diagnosis

Cam type femoral acetabular impingement (FAI) 股骨髋臼撞击综合征-凸轮型

Pincer-type FAI

股骨髋臼撞击综合征-钳夹型

Primary osteoarthritis of the hip

原发性髋关节骨关节炎

Diagnosis

Cam-type femoral acetabular impingement (FAI) 股骨髋臼撞击综合征-凸轮型

Discussion

Femoral acetabular impingement (FAI) is a spectrum of congenital morphologic abnormalities of the acetabulum and proximal femur that represent a major etiology of osteoarthritis of the hip in young patients. The etiology is believed to be repetitive microtrauma to the labrum due to the abnormal biomechanics involved with the congenital abnormality. Two major types are recognized, cam type and pincer type, and they usually present in some combination of the two (86% of patients have both). While a distinct entity, developmental dysplasia of the hip can lead to FAI.

股骨髋臼撞击综合征（FAI）是一组先天性股骨近端及髋臼形态异常，是年轻患者髋关节骨性关节炎的主要原因。其主要病因机制为先天性异常引起生物力学改变，使髋臼盂唇受到反复的微创伤。

FAI主要分为凸轮型（cam type）和钳夹型（pincer type），以及二者混合型（约86%的患者为混合型）。

部分发育性髋关节发育不良可进展为FAI。

Cam type, which is illustrated in this case, describes an abnormal morphology of the femoral head-neck junction. In this type, the abnormal “bump” in the proximal femur impinges on the labrum, which, over time, leads to damage