强直性脊柱炎累及双髋关节—培训课件.pptVIP

* Fig. 4. Coronal view of magnetic resonance imaging of the left greater trochanter; the multicystic lesion extends from the greater trochanter into both the gluteal and femoral muscles. The cyst also protrudes subcutaneouly beyond the fascia lata. The signal of the cyst is low on the T1-weighed image (left) and very high on the T2-weighed image (middle). The superficial cyst exhibits a particularly low signal, and the intramuscular cyst contains small areas exhibiting a similar signal. Gadolinium-enhancement study (right) demonstrates a moderate increase in intensity only in the cyst wall. No enhancement is seen in the cyst cavity * * TB pathogenesis —hematogenous dissemination 15% cases of osteoarticular tuberculosis common age——the second and third decades the most common site——vertebral tuberculosis TB lesions on the acetabular side progress less rapidly than lesions on the femoral side TB clinical symptom common symptom joint symptom pain fixed deformities of the hip painful limitation of movement muscle wasting regional lymph node enlargement form of cold abscess with or without sinuses pathologic dislocation of the hip TB imaging appearance thickening of the synovium subchondral and marginal bony erosion effusion loss of joint space periarticular abscess juxta-articular osteoporosis TB hip dislocation—— uncommon TB tuberculous bursitis——rare common site——trochanteric region hip joint arthritis clinical symptom、age gender、laboratory examination HLA-27(+) AS RF(+) RA Tubercle bacillus TB imaging appearance enthesitis、 osteophytosis、 combined SIJ and spine changes AS obvious synovitis polyarticular、 bone erosion、 uniform narrowing RA monoarticular nonuniform narrowing bone destruction TB Final diagnosis combination Made by chaichao RA Joint TB PVNS Gouty Joint involvement Polyarticular Sy