骨内痛风结节误诊为内生软骨瘤原因分析及防范措施  

Analysis of Causes of Misdiagnosis and Preventive Measures of Intraosseous Gout Nodule Misdiagnosed as Endochondroma

作　　者：王帅 郑凯 WANG Shuai;ZHENG Kai(Department of Orthopedics,the 960th Hospital of the Joint Logistics Support Force of the PLA,Jinan 250000,China)

机构地区：[1]联勤保障部队第九六〇医院骨科,济南250000

出　　处：《临床误诊误治》2024年第18期1-4,共4页Clinical Misdiagnosis & Mistherapy

基　　金：山东省医药卫生科技发展计划(202104071065)。

摘　　要：目的探讨骨内痛风结节误诊为内生软骨瘤的原因及防范措施。方法回顾性分析2022年收治的1例曾误诊的骨内痛风结节患者的临床资料。结果本例因右足踇趾疼痛1周入院,经影像学检查后误诊为内生软骨瘤,拟行肿瘤刮除植骨术,术后病理提示符合痛风结节。确诊为骨内痛风结节。误诊时间为7 d。确诊后予以非布司他降尿酸治疗,切口愈合良好后出院。术后随访1年患者无特殊不适,右足踇趾活动正常。结论骨内痛风结节相对少见,影像学表现与内生软骨瘤相似,易误诊。临床医生应加强对该病的认识,对合并尿酸升高的患者,应考虑到痛风可能,及时完善相关检查,避免误诊。Objective To investigate the causes and preventive measures of misdiagnosis of intraosseous gout nodules as endochondroma.Methods The clinical data of 1 patient with misdiagnosed intraosseous gout nodule admitted in 2022 were retrospectively analyzed.Results This case was admitted to hospital due to pain at great toe of his right foot for 1 week.After imaging examination,it was misdiagnosed as endochondroma.Tumor curettage and bone graft were proposed,and postoperative pathology indicated that it was consistent with gout nodule.The diagnosis was intraosseous gout nodule,and the misdiagnosis lasted 7 d.After diagnosis,Febuxostat was administered to reduce uric acid levels,and the incision healed well before discharge.At 1-year follow-up after surgery,the patient had no special discomfort but normal activity at right great toe.Conclusion Intraosseous gout nodule is relatively rare,and imaging manifestation are similar to enchondroma,which may lead to misdiagnosis.Clinicians should strengthen the understanding of the disease,and for patients with elevated uric acid,the possibility of gout should be considered.The relevant examination should be performed in time to avoid misdiagnosis.

关 键 词：痛风结节 误诊 内生软骨瘤病 尿酸 双能CT 病理学 诊断 鉴别 

分 类 号：R589.7[医药卫生—内分泌]