Thigh muscle atrophy

Introduction The thigh muscle atrophy in patients with femoral head necrosis is a common phenomenon. The weight and weight of muscle atrophy are different. Most of the femoral head necrosis patients can recover from thigh muscle atrophy, but the thigh muscle atrophy of a few femoral head necrosis patients can not be recovered for life, seriously affecting The distance traveled by the patient and the quality of life of the patient. 100% of patients with advanced femoral head necrosis have varying degrees of thigh muscle atrophy in the affected limbs. The impact on the walking of patients with femoral head necrosis is very large, which directly limits the recovery of the thigh of the affected limb and limits the length of walking of the patient.

Cause

The first cause of thigh muscle atrophy is caused by a decrease in blood supply to the thigh of patients with femoral head necrosis. Although the causes of femoral head necrosis vary, the pathogenesis is due to blood circulation disorders around the femoral head. The blood circulation disorder will not only cause necrosis of the femoral head, but also cause insufficient blood supply to the wide tissues of the lower extremity of the femoral artery. In the case of reduced blood supply to the lower limb muscles, the thigh muscles will be malnourished for a long time, which will cause muscle atrophy of the lower limbs. Another reason is that the thigh of the affected limb is not often walking due to pain, the muscles are not effectively exercised for a long time, the muscles are no longer developed, the muscles gradually shrink and become smaller, and the resulting muscle atrophy is caused.

an examination

Related inspection

X-ray examination of mammography

1, early X-ray film can not be found positive, with the progress, trabecular bone disorder occurs in the weight-bearing area, interrupted, after the femoral head subchondral bone cystic change, inclusion hardening. As the lesion progresses, the obstacle is repaired, and a linear translucent area appears in the lesion area, which is surrounded by hardened bone and presents a new moon sign. Late stage collapse, deformation, subluxation, and narrow joint space. The X-ray can determine the extent of the lesion and exclude other lesions of the bone. It has the advantages of simplicity, convenience, economy and wide application range, and is still the basic examination method for femoral head necrosis.

2, also in the early stage of femoral head necrosis, CT films can be normal. CT scan is better than MRI in judging the change of bone structure in the femoral head. It is important to predict the collapse of the femoral head necrosis after diagnosis. Therefore, CT examination is also a common method. Early: The femoral head weight-bearing facial trabecular bone disorder, partial absorption, mixed with thickening, fusion, cystic absorption, partial hardening. CT can show that the new moon sign is a three-layer structure: the center is dead bone, surrounded by a translucent bone absorption band, the outermost part is the new bone hardening bone, the late stage: the femoral head is collapsed and deformed, and the center has a large low density. In the area, a shell-like fracture piece appears under the articular cartilage, and the acetabular lip is prominent, which may have joint deformation.

3, MRI can be found early in the bone necrosis, can be diagnosed before X-ray films and CT films found abnormalities. Multiple signal changes in MRI of the femoral head necrosis reflect the metabolic levels of diseased tissue at different levels. The pathological feature of the T2-weighted image with high signal is the repair reaction caused by bone and bone marrow necrosis. It is characterized by acute inflammatory pathological changes such as bone marrow edema, local congestion and exudation. The T1 weighted image is mostly a low signal. T2-weighted images are shown as mixed signals, high signals suggest inflammation and congestion, edema, and low-signal lesions are mostly fibrotic and hardened. T1 is weighted to a distinctly uneven signal with a crescent-shaped boundary. If the T2-weighted image shows a medium-high signal, and the surrounding unevenness is slightly lower than the signal, it is a typical double-line sign, and the position is basically consistent with the strip-like bone hardening of CT.

4. Radionuclide bone scan (ECT) is also a means of detecting early diagnosis.

Differential diagnosis

Muscle atrophy refers to dystrophy of striated muscle, muscle volume is reduced compared to normal, muscle fibers become thinner or even disappear. Neuromuscular disease is hypertrophy. In addition to the pathological changes of muscle tissue itself, muscle nutrition is closely related to the nervous system. Spinal cord disease often leads to muscular dystrophy and muscle atrophy.

Patients with knee osteoarthritis may have the following signs: muscle atrophy around the joints, especially the quadriceps atrophy of the thigh can occur earlier and more obvious. The joints are swollen, there may be fluid in the joint cavity, and the floating raft test is positive. Attachment of the joint capsule around the knee joint, such as tenderness of the upper end of the humerus, may cause crushing pain when pressing the humerus. In severe cases, the knee joint may have flexion deformity, the knee joint extension and flexion activity is limited, and there is a snoring in the joint during the movement.

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