远端桡尺关节半脱位的CT检查

摘要

目的探讨通过CT检查提高对远端桡尺关节半脱位的诊断率。方法对56例经X线检查可疑为远端桡尺关节半脱位的患者（男36例，女20例）行双侧远端桡尺关节旋前、旋后位CT横断扫描。应用Nakamura的改良桡尺线方法进行测量，经过双侧对比确定尺骨头掌侧或背侧半脱位。结果在56例X线检查拟诊为远端桡尺关节半脱位的患者中，尺骨头掌侧半脱位10例；尺骨头背侧半脱位15例；另有2例为尺骨头背侧半脱位，经与健侧对比确定为假阳性。结论通过CT检查诊断远端桡尺关节半脱位，可减少X线检查由于难以达到标准投照位置所产生的假阳性，从而提高对远端桡尺关节半脱位的诊断率。对曾有腕关节外伤史或逐渐加重的腕部疼痛及远端桡尺关节活动受限者，CT检查是诊断远端桡尺关节半脱位较为有效的方法。%Objective To evaluate the importance of CT in the diagnosis of the subluxation of the distal radioulnar joint (SDRUJ). Methods Transaxial CT scans of the distal radioulnar joint (DRUJ) were performed at pronation and supination position in 56 patients (male 36, female 20) suspected of SDRUJ. The method of modified Nakamura radioulnar line was used on both wrists to determine the presence of dorsal or palmar head of ulna subluxation. Results Of 56 cases with SDRUJ, 10 were palmar subluxation and 15 dorsal subluxation. Two cases with dorsal head of ulna subluxation were false positive as compared with the contralateral normal wrist. Conclusion CT is able to overcome the false positive result from radiography and is an effective screening method in patients suspected of SDRUJ.