双胫骨应力性骨折误诊一例分析并文献复习  

Bilateral tibia stress fractures:an analysis of a misdiagnosed case and literature review

作　　者：邓超华[1] 蔡林[1] 钱崇升[1] 戢涛[1] 

机构地区：[1]武汉大学中南医院骨科,武汉430071

出　　处：《中国骨与关节杂志》2012年第5期554-556,共3页Chinese Journal of Bone and Joint

摘　　要：应力性骨折虽然并不少见，但由于症状进展缓慢，又无确切创伤史，故早期诊断非常困难。我院收治双胫骨中下段应力性骨折1例，左胫骨病变诊断为骨髓炎，然而手术治疗后的病理检查结果却未见骨髓炎性改变，11个月后右胫骨出现同样病变，经过病史分析、高危因素筛查等方法更正诊断为双胫骨应力性骨折。现将病例报道如下。 临床资料 患者，男，16岁。身高：174cm，体重：92kg，BMI（体重指数）：30．38。于2011年3月25日在早晨跑步时出现左小腿内侧疼痛，轻度跛行。无明确外伤史。于1个月后到医院就诊，体温正常，左小腿中下1／3处内侧轻度肿胀，压痛，范围约4cm×5cm，Although stress fractures are not uncommon, it is extremely easy to misdiagnose or miss the diagnosis in early stage because of the slow progression of symptoms and lack of precise history of trauma. The paper reported a rare case of bilateral stress fractures of the middle and distal tibia. The lesion of the left tibia was early misdiagnosed as osteomyelitis. The pathological examination after surgery revealed that there was no such change. After 11 months, the same lesion appeared in the right tibia. However, through the analysis of case history, screening of high-risk factors and so on, the patient was further diagnosed to be tibia stress fractures. And meanwhile, with literature review, the diagnosis, treatment and prevention of stress fractures were reviewed, in order to help the clinical diagnosis of the disease and reduce misdiagnosis.

关 键 词：胫骨应力性骨折 文献复习 误诊 高危因素筛查 早期诊断 病变诊断 体重指数 小腿内侧 

分 类 号：R687.3[医药卫生—骨科学]