tailieunhanh - Chẩn đoán X quang của xương chậu

Vô căn protrusio acetabuli là một quá trình bệnh phổ biến với cả hai hình thức tự phát và trung học chính. Điều quan trọng là xem xét tất cả các khả năng bệnh nguyên trước khi đánh giá các lựa chọn điều trị. Chẩn đoán được thực hiện trên cơ sở X quang anteroposterior của xương chậu | Protrusio Acetabuli Diagnosis and Treatment Mark T. McBride MD Michael P. Muldoon CDR MC USN Richard F. Santore MD Robert T. Trousdale MD and Dennis R. Wenger MD Abstract Idiopathic protrusio acetabuli is an uncommon disease process with both primary idiopathic and secondary forms. It is important to consider all etiologic possibilities before evaluating treatment options. Diagnosis is made on the basis of an anteroposterior radiograph of the pelvis that demonstrates a center-edge angle greater than 40 degrees and medialization of the medial wall of the acetabulum past the ilioischial line. For the skeletally immature patient triradiate fusion occasionally combined with intertrochanteric osteotomy provides good results. For the young adult valgus intertrochanteric proximal femoral osteotomy is recommended. In the older adult this procedure may provide an acceptable result if there is minimal arthritis. For patients with more advanced arthritis total hip arthroplasty with lateralization of the cup to a normal position provides a predictable long-term solution. J Am Acad Orthop Surg 2001 9 79-88 Protrusio acetabuli also known as arthrokatadysis was first described by the German pathologist Otto in 1824. A translated excerpt of Otto s original report provides a vivid description The right acetabulum protrudes into the pelvis like half an orange . . . at the crest corresponding to the center of the acetabular fossa is an irregular circular defect measuring one and one-half inches . . . supplying communication between the acetabulum and abdominal cavity . . . both the inner aspect of the acetabulum and the head of the femur are devoid of cartilaginous covering and have the abraded and polished appearance of some gouty Idiopathic or primary protrusio acetabuli is the diagnosis reserved for patients in whom no causative factors can be found. It is a diagnosis of exclusion as more underlying disease states associated with this condition are recognized the num ber