摘要
硬化性骨髓炎(sclerosing osteomyelitis)又称骨化性骨膜炎(ossifying periostitis),是一种以外周骨质和骨膜硬化,不伴脓肿及窦道形成的慢性疾病[1-2]。其多发于长骨骨干及干骺端,也见于下颚骨[3]。X线检查示弥漫性硬化性改变伴局部骨质溶解[4],有时可见骨膜反应[5]。硬化性骨髓炎较为罕见,特点不典型,诊断具有较高难度。本病应与尤文肉瘤、骨样骨瘤。
Objective To present one adolescent case of humeral metaphysial sclerosing osteomyelitis which is misdiagnosed as Ewing’s sarcoma,and to discuss the clinical characteristics,imaging features,causes of misdiagnosis and treatment.Methods A 13-year-old girl was admitted to our clinic for right shoulder pain and movement limitation after failed conservative treatment.Imageology examination revealed progressive erosive bone destruction at the right humeral metaphysis.Periosteal reaction was obvious.Chemotherapy for malignancy was conducted but failed.Biopsy and curettage were performed and symptoms were relieved.Pathological findings proved that bone destruction was caused by osteomyelitis and it recrudesced at the same position with same symptoms after 1.5 years’remission.Imageology examination showed typical imaging features of sclerosing osteomyelitis with bone sclerosis and periosteal thickening.Antibiotics was given after radical surgical debridement.Results No recurrence was detected postoperatively.Conclusions Imaging features of progressive sclerosing osteomyelitis are atypical,and are easily mixed with bone tumor diseases.Histopathology is the key to its diagnosis.Surgical intervention is direct and effective than conservative treatment.
作者
朱岩
何志伟
樊根涛
朱浩
周光新
ZHU Yan;HE Zhi-wei;FAN Gen-tao;ZHU Hao;ZHOU Guang-xin(Jinling Hospital Department of Orthopedics,Nanjing Medical University,Nanjing,Jiangsu,210002,China)
出处
《中国骨与关节杂志》
CAS
2019年第5期398-400,共3页
Chinese Journal of Bone and Joint
基金
国家自然科学基金面上项目(81472508)
江苏省自然科学基金面上项目(BK20141376)
关键词
骨髓炎
误诊
手术治疗
尤文肉瘤
Osteomyelitis
Diagnostic errors
Surgery
Ewing’s sarcoma
作者简介
通讯作者:周光新,Email:oxis@163.com
