Objective: To study the cause of X-ray misdiagnosis of the avascular femur head necrosis, so as to reduce the misdiagnosis rate and raise the early diagnosis level. Methods:The clinical and X-ray data of 99 patients(123 hips) with avascular femur head necrosis diagnosed by MRI were analyzed retrospectively. Among the patients, 56 patients were male and 43 patients were female, ranging in age from 21 to 84 years old,with an average of 53 years old. The patients had symptoms such as hip pain,functional restriction in flexion,adduction,abduction and internal rotation,and some patients had limping. The duration of the disease ranged from 1 week to 2 years. Results: Among 99 patients(123 hips) ,46 patients(52 hips) was misdi-agnosed by the X-ray,the misdiagnosis rate was 42.27%, 100.00% in 0 stage, 100.00% in Ⅰ stage,83.67% in Ⅱ stage, 18.18% in Ⅲ stage, 0.00% in Ⅳ stage, 0.00% in Ⅴ stage; the X-ray stage was negatively correlated with the rate of misdiagnosis. The careless film-reading and invigorating large enterprises while relaxing control over small ones was the main reason of misdiagnosis,then the lack of clinical histories and low-quality of X-ray projection. Conclusion:The relevant clinical history and comprehensive careful film-reading is the key to reduce the rate of misdiagnosis.%目的:探讨股骨头缺血性坏死的X线漏诊原因,旨在进一步减低漏诊率和提高早期诊断水平.方法:对99例123髋经MRI诊断为股骨头缺血性坏死患者的临床、X线资料进行回顾性分析,男56例,女43例；年龄21～84岁,平均53岁.髋区疼痛,伴屈曲、内收、外展、内旋髋关节功能受限,部分患者出现跛行.病史1周～2年.结果:99例123髋中,X线漏诊46例52髋,漏诊率42.27％,其中0期100.00％,Ⅰ期100.00％,Ⅱ期83.67％,Ⅲ期18.18％,Ⅳ期0.00％,Ⅴ期0.00％,X线分期与漏诊率呈负相关.漏诊的主要原因是阅片不细致和“抓大放小”,其次为临床病史缺乏和X线投照质量低.结论:相应的临床病史和综合、细致地阅片是减低漏诊率的关键.
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