The Imaging Findings of Neuropathic Joint Disease Associated with Chiari Disease
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摘要: 目的:分析Chiari病合并神经性关节病的影像表现。方法:回顾性分析8例Chiari病所致神经性关节病的影像学表现。结果:8例中全部为Chiari病合并脊髓空洞症,其中3例为Chiari病术后。17个关节病累及肩关节11例,肘关节6例。增生为主型7例,影像学表现为关节增生硬化及骨赘形成。吸收为主型10例,影像学表现为关节面不规则骨质碎裂、溶解、残端刀削样改变。两型均可伴骨髓水肿(其中5个部位累及骨干)、关节游离体及关节肿胀积液。X线能较好显示关节脱位、骨质增生硬化及吸收。16层CT结合后处理还可多角度观察到大部分游离体位置及数目。MRI能准确地诊断Chiari病合并的脊髓空洞、显示骨干水肿及软组织改变能力优于X线及CT,水成像序列显示关节积液内微小游离体的能力优于其他检查。结论:X线、CT与MRI检查手段相结合有助于Chiari病合并神经性关节病的影像学诊断。Abstract: Objective:To analyze the imaging findings of neuropathic joint disease caused by Chiari disease. Methods:The imaging data of 8 cases of neuropathic joint disease caused by Chiari disease were retrospectively analyzed. Results:All were Chiari disease complicated with syringomyelia, of them 3 cases after surgery for Chiari disease. 17 joints were involved, among them the shoulder in 11, the elbow in 6. Hyperplasia type in 7 joints, the imagings expressed as joint osteophyte formation and proliferation. Absorbent type in 10 joints, the imagings showed irregular articular surface of bone fragmentation, dissolution, bone marrow edema, nub presented papercut transformation. Two types could be associated with bone marrow edema (of them five parts involving the backbone), joint loose bodies and joint swelling, effusion. X-ray could show the joint dislocation, osteosclerosis and absorption. 16-slice CT combined with post-processing also could show the position and number of the loose bodies from multi-angle. MRI could accurately diagnose Chiari disease complicated with syringomyelia, the ability for MRI to display backbone edema is superior to X-ray and CT, the ability for water imaging sequence in MRI to show the small loose bodies within the joint effusion is superior to other examination. Conclusion:It is helpful for the diagnosis of neuropathic joint disease by Chiari disease with the combination of X-ray, CT and MRI.
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Keywords:
- joint disease /
- neurogenic /
- tomography /
- X-ray computed /
- magnetic resonance imaging
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