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A Study on Usefulness of Planar Bone Scan and Bone SPECT in Diagnosis of Temporomandibular Joint Arthritides
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KMID : 0355220050300010107
Abstract
ÃøµÎÇϾǰüÀý °üÀý¿°Àº °ñ°üÀý¿°, °ñ°üÀýÁõ, ´Ù¹ß¼º °üÀý¿°À¸·Î ³ª´¶´Ù °ñ°üÀý¿°°ú °ñ°üÀýÁõÀº °üÀýÅëÀ» Á¦¿ÜÇÏ¸é ±× Áõ»ó, ¡ÈÄ, ¹æ»ç¼±Àû Ư¡ÀÌ ºñ½ÁÇϱ⠶§¹®¿¡ °¨º°Áø´ÜÀÌ ¾î·Æ´Ù. ¶ÇÇÑ Ãʱ⠰ñ°üÀý¿°ÀÇ °æ¿ì ¹æ»ç¼±Àû º¯È°¡ ³ªÅ¸³ªÁö ¾Ê¾Æ¼ ¿ÀÁøÀ» ÇÒ ¼ö°¡ ÀÖ´Ù.
°ñ½ºÄµ°ú ´Ü±¤ÀÚ¹æÃâ Àü»êÈ ´ÜÃþÃÔ¿µÀº °ñÀÇ º¯È¸¦ Ãʱ⿡ °¨ÁöÇϴµ¥ À¯¿ëÇÏ´Ù. ÀÌ ¿¬±¸´Â °ñ½ºÄµ°ú ´Ü±¤ÀÚ¹æÃâ Àü»êÈ ´ÜÃþÃÔ¿µÀ» ÀÌ¿ëÇÏ¿© Áø´ÜÇÐÀûÀÎ ±âÁØÀ» Á¦½ÃÇϱâ À§ÇÏ¿© ½ÃµµµÇ¾ú´Ù. ÀÓ»ó°Ë»ç, Àü»êÈ´ÜÃþ ÃÔ¿µ, °ñ½ºÄµ, ´Ü±¤ÀÚ¹æÃâ Àü»êÈ ´ÜÃþÃÔ¿µÀ» ½Ç½ÃÇÑ 304°³ÀÇ ÃøµÎÇϾǰüÀýÀ» ´ë»óÀ¸·Î ¿¬±¸ÇÏ¿´´Ù.
¿¬±¸°á°ú ´ÙÀ½°ú °°Àº °á·ÐÀÌ µµÃâµÇ¾ú´Ù.
1. °ñ½ºÄµÀ» ÀÌ¿ëÇÏ¿© ÃøµÎÇϾǰüÀýÀ» Áø´ÜÇϴµ¥ ÀÖ¾î¼ 20´ë ȯÀÚÀÇ ´Ü¼ø¼·ÃëÀ²ÀÌ 1.397% ÀÌ»óÀÎ °æ¿ì, 30¡40´ë ȯÀÚÀÇ ´Ü¼ø¼·ÃëÀ²ÀÌ 1.332% ÀÌ»óÀÎ °æ¿ì¿¡´Â °ñ°üÀý¿°À¸·Î ÃßÁ¤ÇØ º¼ ÇÊ¿ä°¡ ÀÖ´Ù.
2. ´Ü±¤ÀÚ¹æÃâ Àü»êÈ´ÜÃþ ÃÔ¿µÀ» ÀÌ¿ëÇÏ¿© ÃøµÎÇϾǰüÀýÀ» Áø´ÜÇϴµ¥ ÀÖ¾î¼ ¿ÂÁ¡ÀÌ °üÂûµÇ´Â °ü»ó´Ü¸é, Ⱦ´Ü¸éÀÌ 4°³ ÀÌ»óÀÏ °æ¿ì¿¡´Â °ñ°üÀý¿°À¸·Î ÃßÁ¤ÇØ º¼ ÇÊ¿ä°¡ ÀÖ´Ù.
3. °ñ½ºÄµÀ» ÀÌ¿ëÇÏ¿© ÃøµÎÇϾǰüÀýÀ» Áø´ÜÇϴµ¥ ÀÖ¾î¼ 20´ë ȯÀÚÀÇ ´Ü¼ø¼·ÃëÀ²ÀÌ 1.370% ÀÌ»óÀÎ °æ¿ì, 30-40ȯÀÚÀÇ ´Ü¼ø¼·ÃëÀ²ÀÌ 1.104% ÀÌ»óÀÎ °æ¿ì¿¡´Â °ñÆı« °úÁ¤ÀÌ ÁøÇàÁßÀÎ °ÍÀ¸·Î »ý°¢ÇØ º¼ ÇÊ¿ä°¡ ÀÖ´Ù.
4. ´Ü±¤ÀÚ¹æÃâ Àü»êÈ´ÜÃþ ÃÔ¿µÀ» ÀÌ¿ëÇÏ¿© ÃøµÎÇϾǰüÀýÀ» Áø´ÜÇϴµ¥ ÀÖ¾î¼ 20´ë¿Í 30-40´ë¿¡¼ ¿ÂÁ¡ÀÌ °üÂûµÇ´Â °ü»ó´Ü¸éÀÌ 4°³ ÀÌ»óÀÏ °æ¿ì¿¡´Â °ñÆı« °úÁ¤ÀÌ ÁøÇàÁßÀÎ °ÍÀ¸·Î, ¸ðµç ¿¬·É¿¡¼ ¿ÂÁ¡ÀÌ °üÂûµÇ´Â Ⱦ´Ü¸éÀÌ 3°³ ÀÌ»óÀÏ °æ¿ì¿¡´Â °ñÆı« °úÁ¤ÀÌ ÁøÇà ÁßÀÎ °ÍÀ¸·Î »ý°¢ÇØ º¼ ÇÊ¿ä°¡ ÀÖ´Ù.
5. ÀÓ»óÀûÀ¸·Î ÁÖ°üÀû °üÀýÅë°ú ÃËÁøÅëÀÌ ¸ðµÎ ³ªÅ¸³ °æ¿ì¿¡ °ñº¯È°¡ ´õ¿í È°¹ßÇÒ °¡´É¼ºÀÌ ³ô´Ù.
6. °üÀýÀ½, °üÀýÅë, °³±¸Á¦ÇÑÀÇ º´·ÂÀÌ 4.5°³¿ù±îÁö Á¡Â÷ ±æ¾îÁú ¼ö·Ï ÃøµÎÇϾǰüÀýÀº °ñ°üÀý¿°À¸·Î Á¡Â÷ ¾Çȵǰí, ±× ÀÌÈÄ¿¡´Â °ñ°üÀýÁõÀ¸·Î Á¡Â÷ ¾ÈÁ¤ÈµÇ´Â °æÇâÀ» º¸¿´´Ù.
Temporomandibular joint arthritides is divided into osteoarthritis, osteoarthrosis and polyarthritis. Because the signs, symptoms and radiographical features of osteoarthritis and osteoarthrosis are similar without arthralgia, diffenential diagnosis is difficult. Also non-radiographically change in early Osteoarthritis leads to misdiagnose.
Planar bone scan and SPECT are useful to detect bone change early. This study was carried out in order to make diagnostic criteria of planar bone scan and SPECT. Three hundred and four temporomandibular joints were examined with clinical examination, computerized tomograph, planar bone scan, and SPECT.
The obtained results were as follows.
1. If temporomandibular joint simple uptake ratio of patient in twenties is over 1.397%, it¢¥s condition may be osteoarthritis. And simple uptake ratio over in thirties-fourties may mean osteoarthritis.
2. It may mean osteoarthritis of temporomandibular joint that the number of coronal and transverse SPECT frame with hot spot is over four.
3. Destructive stage may goes on, if simple uptake ratio is over 1.370% in tweenties and over 1.104% in thirties-fourties.
4. If the number of coronal SPECT frame with hot spot is over four, temporomandibular joint may be on destructive stage in tweenties, thirties-fourties. And if the number of transverse SPECT frame with hot spot is over three, it may be on destructive stage in all ages.
5. When patient complains subjective arthralgia and palpation arthralgia, bone change may be more active than each arthralgia.
6. Osteoarthritis may progress gradually worse in 4.5 anamnesis. And then it may be stable gradually and turn to osteoarthrosis.
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