放射線檢查對血友病性關節病變的評估

Radiological Evaluation of Hemophilic Arthropathy

陳昶男(C.N Chern)；田雨生(Y.S Tyan)；沈文川(W.C Shen)；張政彥(C. Y Chang)；張遵(T. Chang)

血友病 ； 關節病變 ； 關節腔血腫 ； hemophilia ； arthropathy ； hemarthrosis

中華放射線醫學雜誌

13卷3期（1988 / 09 / 01）

285 - 290

繁體中文

血友病性關節病變是血友病最常見的併發症，因嚴重的出血傾向造成關節腔血腫，接著進行關節病變，其中以四肢的大關節最為顯著。在本文35例血友病患中，因關節出現臨床症狀而第一次接受放射線檢查時，發現27例(77%)，共76個關節有關節病變的放射線表徵。其中以膝關節發生病變最多，依次為踝、肘、髖及肩關節。10歲以下的患者約50%出現關節病變，隨年齡的增加陽性率也跟著增加，到20歲以上則高達92%。關節病變的嚴重程度也隨年齡的上升而升高，10歲以下的患者病變程度超過第Ⅲ期的僅31%，在20歲以上的患者則升為82%。換句話說，20歲以上的血友病患關節出現臨床症狀時，幾乎關節均已發生病變，且高達82%已失去了治癒的機會。故早期的放射線檢查與評估，對阻止血友病患者的關節病變有莫大的幫助。

Hemophilia is a group of hereditary, hemorrhagic blood disorders characterized by abnormal blood coagulation and excessive bleeding. The bleeding tendency is the source of hemarthrosis and hemophilic arthropathy, which is the most common complication of the hemophilia and chiefly involve the large joints of extremities. We collected 35 cases of hemophilia who had received the conventional radiological examination due to clinical symptoms of joint disorders. Totally 27 cases (including 76 joints) have the radiological features of hemophilic arthropathy. According to the radiological features, we have analized and classified those cases according to the age group and location of involvement. Comparision and review with other reports were made.