高频超声在诊断儿童难复性桡骨小头半脱位中的应用价值

摘要

目的 探讨诊断儿童难复性桡骨小头半脱位的高频超声检查方法.方法 急诊对24例难复性单侧桡骨小头半脱位儿童(年龄1～5岁)行双侧肘关节多切面高频超声及X线检查,6例行MR检查,并与健侧对比,观察不同超声切面患侧桡骨小头相对于肱骨小头的位置变化关系.结果 肘关节X线检查均未检出桡骨小头半脱位,高频超声检出桡骨小头半脱位24例,均伴有关节腔积液,MR检出6例,伴有关节腔积液者4例.结论 在儿童难复性桡骨小头半脱位诊断方面,高频超声的敏感性明显高于X线片,与MR检查相似;尤其是前区桡侧纵切面、外侧区纵切面在急诊无创检查儿童难复性桡骨小头半脱位方面具有明显优势.%Objective To explore the application of high frequency ultrasonography in the rapid diagnosis of irreducible radial bead subluxation in children.Methods Bilateral high-frequency ultrasonography and X-ray examinations of the elbow were done in the emergency room for 24 children (age 1 to 5 years) suspected with unilateral irreducible radial head subluxafion.Six of them also had MRI.Compared with the contralateral side,the relative position of the radial head to the capitellum wns observed under various US axes.Results None of the radial head suhluxation was detected by X-rays.Radial bead subluxation was detected by high frequency ultrasonography in all 24 cases,with joint space effusion.MRI revealed 6 cases of radial head subluxation,among which 4 had joint space effusion.Conclusion The sensitivity of high frequency ultrasonography in the rapid diagnosis of irreducible radial head subluxation in children is considerably higher than that of X-ray,while being similar to that of MRI.High frequency ultrasonography through the anteroradial longitudinal section and lateral longitudinal section are particularly effective in quick and clear diagnosis of radial head subluxation in children.