非典型骨髓炎的影像学表现及治疗  

Radiography,clinical diagnosis and treatment of atypical pyogenic osteomyelitis

作　　者：张开刚[1] 尚凯[1] 马玉栋[1] 王军[1] 

机构地区：[1]泰安市中心医院骨科,山东泰安271000

出　　处：《临床骨科杂志》2012年第1期26-28,共3页Journal of Clinical Orthopaedics

摘　　要：目的分析非典型骨髓炎的影像学表现探讨诊疗方法。方法观察24例非典型骨髓炎患者影像学表现,并与手术病理结果进行对照。结果 24例患者术后病理均证实为骨髓炎。显示软组织肿胀:X线平片10例,CT 18例,MRI 21例;显示骨膜反应:X线平片15例,CT 18例,MRI未见;显示骨髓腔密度增高:X线平片11例,CT 16例,MRI 24例;显示骨皮质增厚:X线平片10例,CT 14例,MRI 18例。结论 MRI对非典型骨髓炎的早期诊断、鉴别诊断帮助较大,X线平片仍是基础。X线平片、CT结合MR检查是非典型骨髓炎的早期诊断和鉴别诊断的重要手段。非典型慢性骨髓炎影像学表现不典型,误诊、漏诊率较高,认识其临床及影像学表现可以提高诊疗水平。Objective To analyze the radiography features of clinical atypical pyogenic osteomyelitis and to explore treatment method. Methods The radiography signs of 24 cases with atypical pyogenic osteomyelitis, were compared with the surgical pathology findings. Results The post operational pathology of 24 cases were confirmed atypical py- ogenic osteomyelitis. Demonstrates soft tissue swelling case： X-ray plain film 10 cases, CT 18 cases, MRI 21cases ; demonstrates periosteal reaction ： X-ray plain film 15 cases, CT 18 cases, MRI 0 cases ; demonstrates increased density of marrow cavity ： X-ray plain film 11 cases, CT 16 cases, MRI 24 cases ; demonstrates thickening of bone cortex ： X- ray plain film 10 cases,CT 14 cases,MRI 18 cases. Conclusions MRI helps a lot in early diagnosis and differentia/ diagnosis of atypical pyogenie osteomyelitis, whereas X-ray plain radiography is still the basis of each diagnosis. X- ray, CT with MR imaging is an important means in the early diagnosis and differential diagnosis of atypical pyogenic osteomyelitis. Atypical imaging findings of chronic osteomyelitis is not typical, misdiagnosis rate was relatively high, awareness of the clinical and imaging findings can improve the level of diagnosis and treatment about this kind of oste- omvelitis.

关 键 词：骨髓炎/放射摄影术 骨髓炎/治疗 

分 类 号：R681.21[医药卫生—骨科学]