変形性股関節症における疼痛発現部位の検討

Frequency Distribution of Pain in Osteoarthritis of the Hip

　臼蓋形成不全による末期変形性股関節症49例55関節（平均年齢63.8歳）を対象に，疼痛発現部位と診断遅延の関係を検討した．疼痛発現部位は鼠径部47例85％，殿部20例36％，大転子部8例15％，腰部6例11％，大腿前面9例16％，膝前面12例22％であった．51股93％は初診時に診断されたが，4例7％では平均14.5カ月と著しく診断が遅れた．初診時に診断された群の疼痛発現部位は鼠径部が有意に多く，診断が遅れた群では膝前面が有意に多かった．高齢者で膝痛を訴える場合には関連痛の可能性を考慮し，股関節疾患を鑑別する必要がある．

　The purposes of this study was to clarify the relationship between the frequency distribution of pain and diagnostic delay in osteoarthritis of the hip in adults. The location of the pain in the 49 patients (55 hips) was the groin in 47 hips (85％), the buttock in 20 (36％), the greater trochanter in 8 (15％), the low back in 6 (11％), the anterior thigh in 9 (16％), and the knee in 12 (22％). Although the diagnosis was established on the first day in 51 hips (93％), in 4 hips (7％) the diagnosis was significantly delayed by a mean interval of 14.5 months. Knee pain was more common in the diagnostic delay group, and groin pain was less common. Differential diagnosis of hip pathology is recommended in eldery patients with unexplained knee pain, which should be assumed to be referred pain.