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• W2944962893 abstract "Objective. To evaluate the role of integrated use of standard X-ray methods and computed tomography in evaluation of severity of joint destruction in patients with hemophilia. Material and methods. The work is based on an analysis of results of examination and treatment of 87 patients with hemophilic arthropathy of large joints. They treated in specialized department of replacement orthosurgery and polytrauma JSC “RNTSNMP”, with an average age of 42.5 ± 10.3 years, which hemophilia A found in laboratory studies. They are disabled II-III group since childhood. X-rays of the joints before surgery arthroplasty performed, computed tomography was performed on device “Siemens”. Indications for hospitalization wasviolation of large joints: all affected joints 113-104 knee and 9 hip joints. Results and discussion. We used the clinicoradiological classification EZ Novikova (1967) when using standard X-ray to assess severity of joint destruction in patients with hemophilia. It found according to X-ray of the 104 examinated knee in 26% revealed no pathology, I X-ray stage set to 5.8%, II stage - in 6.7%, 37.5% - X-ray revealed signs of arthrosis stage III, in 24% - IV stage. X-ray picture in all 9 patients with complaints of pain in the hip joint is consistent with stage III-IV osteoarthritis, with significant violation of joint function. In recent years, X-ray computed tomography (CT) received widely using to assess bone changes at joint pathology , but literature don’t have enough information about CT descriptions to clarify the stage of progression with hemophilic arthropathy, there is no clear description of CT semiotics at different stages of hemophilic arthritis. After X-ray computed tomography examination is studied 104 knee: 26% of joints that did not have X-ray evidence of osteoarthritis - on CT scans revealed changes corresponding to stages I and II. All these joints defined CT signs of osteoporosis in the form of local areas of bone vacuum, whereas these are not visible in X-ray. It shows, that X-raydoes not give positive result in Istage of disease. At CT of 104 knee joints: from 26% of the joints which didn't have an arthrosis X-ray signs on roentgenograms for CT I and II stages of arthrosis, in all joints - CT-symptoms of osteoporosis in the form of local sites of discharge of a bone tissue whereas on roentgenograms regionarny osteoporosis was noted in 50,6% are revealed. CT, unlike X-rays, has high sensitivity characteristics in diagnosis of hemophilic arthropathy (91.8% and 72.7%), whereas specificity of X-ray is higher CT specificity (86.4% and 71.3%). These two studies are not expected each other, but complemented. The combination of X-ray + CT increases sensitivity to 96.7%, the ratio of TM and DS at the same time is optimal (3:2). Conclusion. Our method of semiquantitative evaluation of hemophilic osteoarthritis’s progression by standard X-ray. computed tomography data supplemented with detailed X-ray tomographic semiotics various stages of hemophilic arthropathy, with diagnostic sensitivity of 96.7% can serve as practical guidelines for physician radiologists, hematologists, orthopedic traumatologist. Timely establishment of changes in joints with hemophilia promotes appointment of adequate therapy, which can affect prognosis of disease evolution and reveals indications for total joint replacement." @default.
• W2944962893 created "2019-05-29" @default.
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• W2944962893 date "2014-12-28" @default.
• W2944962893 modified "2023-09-25" @default.
• W2944962893 title "Рентгенография и рентгеновская компьютерная томография в диагностике гемофилических артропатий" @default.
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