of Hip Department Of Pulmonary Medicine髋关节结核肺科课件.ppt

* normal left hip * type of tuberculosis of the right hip. showing osteopenia and acetabular cysts (a). She had an excellent result at 2-year follow-up (b). All * * * WANDERING ACETABULUM * space almost obliterated (a) Radiograph demonstrates complete joint destruction in the right hip, along with associated soft-tissue swelling and calcification. * type of disease of the left hip. * PVNS - lack of osteopenia,heavy hemosiderin deposits causes prominent hypointensity PERTHES DS - absence of metaphyseal changes and presence of juxta articular osteopenia favours TB * * . * ?. * * * Variables Pyogenic (non-tubercular) TB Radiological progression Rapid,short history Slow, insidious onset Marginal erosions Early (wt.bearing areas) Late (non wt. bearing Joint space narrowing Early Late Periostitis Common Rare (thin and parallel) Sclerosis Present +/- Osteoporosis Minimal Marked Ankylosis Bony (common) Fibrous except in spine where bony * d) Congenital dislocation of hip – Limp is painless, generally detected at birth. Telescopy test is positive and X-ray are decisive. e) Congenital coxavara – Painless limp, abduction and internal rotation are limited.Adduction and external rotation maybe increased. X-ray usually confirms the diagnosis. f) Perthe’s Disease –Seen in age group of 5-10 years, associated with minimal limitation of movements,mainly abduction and internal rotation. Typical X-ray changes are out of proportions to the physical findings. The joint space may be widened (unlike TB). Absence of metaphyseal changes and presence of juxta articular osteopenia favours TB g) Osteoarthritis – occurs in older individuals. - Hip movements are limited in all directions but only terminally . - Associated pain and crepitus . h) PVNS - lack of osteopenia,heavy hemosiderin deposits causes prominent hypointensity