股関節疾患の脈管学的研究 特に変形性股関節症を中心とした動的観察
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概要
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Experiments were performed on the hip joints of young rabbits in order to set up the deformity of the femoral head.<BR>By employing the methods of arteriography, microangiography and Spalteholz's technique, it is cleared that the A. retinacularis superior is more apt to be injured by the deformity than the A. retinacularis inferior in the arterial pattern surrounding the femoral head.<BR>Clinically, two series of films by arteriography and intraosseous venography were taken in the 58 patients with hip joints diseases and following results were obtained.<BR>1. Arteriograms of the affected side show the prolongation of time in passing contrast media mostly in all cases and especially remarkable in the A. circumflexa medialis femoris.<BR>2. When a marked deformity is seen in the femoral head, the ascending branch of the A. circumflexa medialis femoris is apt to form a blind loop.<BR>3. A. retinacularis superior was successfully shown in 77 among 111 joints, and A. retinacularis inferior in 94 joints. The side of the cases in which they failed to be demonstrated were mostly the affected.<BR>4. On the intraosseus venography, the affected side in osteoarthritis def ormans showed marked prolongation of disappearing the contrast media.<BR>5. The distribution of the contrast media through the bone marrow can be divided into 3 types; the venous type, infiltrating type, and intermediate type. The former type is frequently seen in the healthy side, while the latter type in the diseased side.<BR>6. In secondary osteoarthritis def ormans of the hips, some cases were thought to have changes in the vasculature resulted from deformity of the femoral head.<BR>7. It was emphasized that the changes of the femoral head could be missed or diagnosed faultly unless roentogenography with contrast medium be done periodically.<BR>The size and course of the blood vessels may vary considerably amang different individuals. Therf ore, comparative examination in each patient should be carried out on both healthy and affected sides.
- 昭和大学・昭和医学会の論文