PDF(Pubmed)
Abstract：
BACKGROUND: In this retrospective case investigation, we analysed the data of patients with osteonecrosis of the femoral head (ONFH) to reveal demographic and clinical diagnostic features of ONFH in three northeastern provinces of China and provide a reference for its prevention, diagnosis, and treatment.
METHODS: We collected data from patients in Beijing Orthopaedic Hospital of Liaoning, focusing on the aetiology and diagnosis of ONFH. Medical records and self-designed questionnaires were used to collect information for statistical analysis, including age, aetiology, reason for glucocorticoid use, hospital level at first visit, and diagnosis.
RESULTS: In total, 906 patients with complete medical records were included in the analysis. The mean patient age was 47.65 ± 12.12 years. The peak age distribution was in the 40s for men and the 50s for women. Among the total cohort, 72 patients (7.95%; 40 men and 32 women) had traumatic ONFH, 198 (21.85%; 131 men and 67 women) had steroid-induced ONFH, 230 (25.39%; 121 men and 109 women) had idiopathic ONFH, and 406 (44.81%; 397 men and 9 women) had alcohol-induced ONFH. Six hundred and twenty patients were diagnosed with ONFH at the first visit, while 286 patients were misdiagnosed, with a diagnosis rate of 68.43%. The diagnosis rate at the first visit in tertiary hospitals was 76.14%. The diagnosis rate at the first visit in second-class hospitals was 52.07%.ONFH was most likely to be misdiagnosed as lumbar disc herniation.
CONCLUSIONS: Most patients with ONFH in three northeastern provinces of China were middle-aged, male, and had alcohol-induced ONFH. The misdiagnosis rate of ONFH at the first visit was very high, especially for misdiagnosis of lumbar disc herniation, indicating that the diagnosis of ONFH requires further improvement.
METHODS: We collected data from patients in Beijing Orthopaedic Hospital of Liaoning, focusing on the aetiology and diagnosis of ONFH. Medical records and self-designed questionnaires were used to collect information for statistical analysis, including age, aetiology, reason for glucocorticoid use, hospital level at first visit, and diagnosis.
RESULTS: In total, 906 patients with complete medical records were included in the analysis. The mean patient age was 47.65 ± 12.12 years. The peak age distribution was in the 40s for men and the 50s for women. Among the total cohort, 72 patients (7.95%; 40 men and 32 women) had traumatic ONFH, 198 (21.85%; 131 men and 67 women) had steroid-induced ONFH, 230 (25.39%; 121 men and 109 women) had idiopathic ONFH, and 406 (44.81%; 397 men and 9 women) had alcohol-induced ONFH. Six hundred and twenty patients were diagnosed with ONFH at the first visit, while 286 patients were misdiagnosed, with a diagnosis rate of 68.43%. The diagnosis rate at the first visit in tertiary hospitals was 76.14%. The diagnosis rate at the first visit in second-class hospitals was 52.07%.ONFH was most likely to be misdiagnosed as lumbar disc herniation.
CONCLUSIONS: Most patients with ONFH in three northeastern provinces of China were middle-aged, male, and had alcohol-induced ONFH. The misdiagnosis rate of ONFH at the first visit was very high, especially for misdiagnosis of lumbar disc herniation, indicating that the diagnosis of ONFH requires further improvement.
摘要：
背景：在这项回顾性病例调查中，我们分析了股骨头坏死（ONFH）患者的资料，以揭示中国东北三省ONFH的人口统计学和临床诊断特征，为其预防提供参考。诊断,和治疗。
方法：我们收集了辽宁省北京骨科医院患者的数据，重点关注ONFH的病因和诊断。使用病历和自行设计的问卷收集信息进行统计分析，包括年龄,病因学，使用糖皮质激素的原因，医院级别的第一次访问，和诊断。
结果：总计，分析中纳入了906例有完整医疗记录的患者。患者平均年龄为47.65±12.12岁。男性的年龄分布高峰在40岁，女性在50岁。在整个队列中，72例患者（7.95%；40名男性和32名女性）有创伤性ONFH，198（21.85%；131名男性和67名女性）患有类固醇诱导的ONFH，230名（25.39%；121名男性和109名女性）患有特发性ONFH，406人(44.81%;397名男性和9名女性)患有酒精诱导的ONFH。六百二十名病人在第一次就诊时被诊断为ONFH,286例误诊,诊断率为68.43%。三级医院首诊诊断率为76.14%。二级医院首诊诊断率为52.07%。ONFH最容易误诊为腰椎间盘突出症。
结论：中国东北三省的ONFH患者大多数为中年人，男性,并且患有酒精诱导的ONFH。首次就诊时ONFH的误诊率很高，尤其是腰椎间盘突出症的误诊,表明ONFH的诊断需要进一步改进。
方法：我们收集了辽宁省北京骨科医院患者的数据，重点关注ONFH的病因和诊断。使用病历和自行设计的问卷收集信息进行统计分析，包括年龄,病因学，使用糖皮质激素的原因，医院级别的第一次访问，和诊断。
结果：总计，分析中纳入了906例有完整医疗记录的患者。患者平均年龄为47.65±12.12岁。男性的年龄分布高峰在40岁，女性在50岁。在整个队列中，72例患者（7.95%；40名男性和32名女性）有创伤性ONFH，198（21.85%；131名男性和67名女性）患有类固醇诱导的ONFH，230名（25.39%；121名男性和109名女性）患有特发性ONFH，406人(44.81%;397名男性和9名女性)患有酒精诱导的ONFH。六百二十名病人在第一次就诊时被诊断为ONFH,286例误诊,诊断率为68.43%。三级医院首诊诊断率为76.14%。二级医院首诊诊断率为52.07%。ONFH最容易误诊为腰椎间盘突出症。
结论：中国东北三省的ONFH患者大多数为中年人，男性,并且患有酒精诱导的ONFH。首次就诊时ONFH的误诊率很高，尤其是腰椎间盘突出症的误诊,表明ONFH的诊断需要进一步改进。
