类鼻疽骨髓炎临床与影像学表现(附17例报告)  

Clinical and Imaging Manifestations of Osteomyelitis Like Malleolus (Report of 17 Cases)

作　　者：施玉森[1] 孙龙 苏兰芳 俞安乐[1] SHI Yusen;SUN Long;SU Lanfang(Department of Radiology,the First Affiliated Hospital of Hainan Medical College,Haikou,Hainan Province 570102 P.R.China)

机构地区：[1]海南医学院第一附属医院放射科,海口570102

出　　处：《临床放射学杂志》2024年第3期409-413,共5页Journal of Clinical Radiology

基　　金：国家重点研发计划“病原学及防疫技术体系研究”重点专项2022年度项目(编号:2022YFC2305001)(注:《边境热点地区传染病病原特征与流行规律研究》为《边境热点地区传染病病原特征与流行规律研究》的子课题1)。

摘　　要：目的 探讨类鼻疽骨髓炎患者的临床与影像学特点。方法 回顾性分析确诊的17例类鼻疽骨髓炎患者的临床及影像学资料。结果 17例患者均为海南本地人,其中14例(82.4%)为中年男性农民,11例(64.7%)有糖尿病史,11例(64.7%)合并两肺结节和(或)结节伴空洞,9例(52.9%)并发脓毒血症。10例行DR检查;10例行CT检查;14例行MRI检查。10例CT结果均显示骨质破坏,破坏区周围骨质增生硬化征象轻微;其中5例显示细碎死骨,未见大块死骨。10例DR结果中,5例显示轻微骨膜反应。17例均显示明显软组织肿胀和(或)较大脓肿。结论 类鼻疽骨髓炎具有独特的流行病学特点和临床表现,且与常见骨髓炎相比,其影像学表现具有相对特征性,综合分析患者临床及影像学资料有助于提高对该病的诊断准确率。Objective To investigate the clinical and radiological characteristics of patients with rhinoscleroma osteomyelitis.Methods A retrospective analysis was conducted on clinical and radiological data of 17 cases of confirmed melioidosis osteomyelitis from 2002 to 2022.Results All 17 patients were local residents of Hainan,China.Among them,14 cases(82.4%) were middle-aged male farmers,11 cases(64.7%) had a history of diabetes,11 cases(64.7%) had bilateral lung nodules and/or nodules with cavitation,and 9 cases(52.9%) had concurrent septicemia.DR examination was performed in 10 patients,CT examination in 10 patients,and MR examination in 14 patients.CT results of 10 cases showed bone destruction with mild new bone formation and sclerosis around bone destruction zone.Among them,5 cases showed fragmented necrotic bone,and no large necrotic bone was observed.Among the 10 DR results,5 cases showed mild periosteal reaction.All 17 patients showed significant soft tissue swelling and/or large abscesses.Conclusion Melioidosis osteomyelitis exhibits unique epidemiological characteristics and clinical manifestations.Compared to common osteomyelitis,its radiological features are relatively characteristic.Comprehensive analysis of clinical and radiological data can contribute to improving the diagnostic accuracy of this disease.

关 键 词：类鼻疽 伯克霍尔德菌 X线计算机 体层摄影术 磁共振成像 

分 类 号：R681.2[医药卫生—骨科学] R816.8[医药卫生—外科学] R445.2[医药卫生—临床医学]