目的 探讨膝关节类风湿性关节 炎（RA）与骨关节炎(OA)的临床异同点及 MRI影像学表现。方法 选取医院收治的 膝关节类风湿性关节炎(RA)患者35例与 骨关节炎(OA)患者41例作为研究对象， 均行MRI检查。结果 RA组Ⅲ-Ⅳ级外侧胫 骨关节股骨外踝、Ⅲ-Ⅳ级胫骨外侧平台 损伤率分别为94.29%、100%较OA组0.0%、 0.0%高，差异具有统计学意义(P<0.05)； RA组外侧胫骨关节股骨外踝、胫骨外侧平 台骨髓水肿、囊性坏死的几率较OA组高， OA组无1例出现外侧胫骨关节病变，差异 具有统计学意义(P<0.05)；RA组内侧前 角、体部、后角半Ⅱ-Ⅲ级月板损的几率 分别为97.14%、94.28%、97.14%较OA组 12.19%、29.27%、14.64%高；RA组外侧前 角、体部、后角Ⅱ-Ⅲ级半月板损伤的几 率分别为85.71%、88.57%、88.57%较OA组 4.88%、4.88%、7.31%高，差异具有统计 学意义(P<0.05)；RA组关节囊内滑膜增 生、肥厚的几率为94.29%较OA组19.51% 高，差异具有统计学意义。结论 RA关节 软骨、软骨下骨病变下及半月板病变程度 较OA严重，MRI影像学检查在RA、OA鉴别 诊断中具有较高的应用价值。

Objective To explore the clinical similarities and differences between knee rheumatoid arthritis and osteoarthritis and MRI imaging manifestations. Methods 35 patients with knee rheumatoid arthritis (RA) and 41 patients with osteoarthritis (OA) admitted into the hospital were selected as the research object and all received MRI examination. Results In RA group, the damage rates of lateral tibial femoral lateral malleolus of grade III–IV and tibial plateau of grade III–IV respectively were 94.29% and 100% which were higher than 0% and 0% of the OA group and the difference was statistically significant (P<0.05). The probabilities of lateral tibial femoral lateral malleolus, bone marrow edema of tibial plateau and cystic necrosis in RA group were higher than those in OA group. There was no lateral tibial articular lesion in OA group and the difference was statistically significant (P<0.05), the ratios of grade II-III meniscus injury in inside anterior angle, somatic part and the merocerite of RA group respectively were 97.14%, 94.28% and 97.14% which were higher than 12.19%, 29.27% and 14.64% of OA group. The ratios of grade II-III meniscus injury in lateral anterior angle, somatic part and the merocerite of RA group respectively were 85.71%, 88.57% and 88.57% which were higher than 4.88%, 4.88% and 7.31% of the OA group and the differences were statistically significant (P<0.05). The ratios of hyperplasia and freshy joint capsule synovium in RA group was 94.29% which were higher than 19.51% in OA group and the difference was statistically significant. Conclusion The degree of the lesions of cartilago articularis, subchondral bone and meniscus was more serious than that of OA. MRI imageological examination was of high value in the differential diagnosis of RA and OA.