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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:

第23卷

期數(shù):

2011年11期

頁碼:

31-33

欄目:

影像診斷

出版日期:

2011-11-30

文章信息/Info

Title:

X-ray Features of Diabetic Osteolysis

作者:

邱乾德²; 趙余祥¹; 林達¹; 蔡慶虎¹; 胡明哲¹; 項劍瑜¹

1.浙江省溫州市第三人民醫(yī)院,浙江 溫州,325002; 2.浙江省 溫州市第八人民醫(yī)院,浙江 溫州 325000

Author(s):

QIU Qian-de^*; ZHAO Yu-xiang; LIN Da; et al.^*

The Third People's Hospital of Wenzhou,Wenzhou 325000,Zhejiaing,China

關(guān)鍵詞:

糖尿病 骨質(zhì)溶解 X線平片

Keywords:

Diabetes Mellitus;  Osteolysis;  X-ray

摘要:

目的:探討糖尿病性骨質(zhì)溶解X線特點,以提高對本病認(rèn)識。方法:回顧性分析經(jīng)臨床確診的33例糖尿病性骨質(zhì)溶解患者的X線表現(xiàn)。33例中男20例,女13例。年齡45～81歲,平均61歲。患糖尿病史9～23年,平均12年。結(jié)果:33例共累及47塊骨,其中趾骨18例26塊,跖骨9例14塊,楔狀骨4例5塊,骰骨1例1塊,跟骨1例1塊。X線表現(xiàn)為骨質(zhì)呈斑片狀溶解17例累及22塊骨; 斑塊狀完全溶解缺如,溶解區(qū)無殘留骨組織者6例累及10塊骨; 多囊狀溶解破壞者4例累及9塊骨; 骨干的一端溶解,呈“削鉛筆尖樣”3例累及3塊骨; 骨干部分骨質(zhì)溶解、消失,且關(guān)節(jié)端骨質(zhì)基本正常,呈“圖釘征”3例累及3塊骨; 溶解邊緣的骨質(zhì)均無硬化,溶解區(qū)附近骨質(zhì)均未見骨膜增生和骨皮質(zhì)增厚,溶解區(qū)均無死骨; 腫脹的軟組織內(nèi)多發(fā)積氣者8例; 軟組織內(nèi)多發(fā)斑片狀鈣化者5例。結(jié)論:糖尿病性骨質(zhì)溶解的X線征象以斑塊狀、斑片狀、多囊狀骨質(zhì)溶解破壞,病變邊緣骨質(zhì)無硬化、無骨膜反應(yīng)、無死骨為特征。

Abstract:

Objective:To study X-ray features of diabetic osteolysis to improve its diagnosis.Methods:X-ray findings of 33 cases with diabetic osteolysis confirmed by clinical follow-up were retrospectively analyzed.There were 20 males and 13 females,aged from 45-81 years with mean age of 61 years.Diabetes history 9-23 years(mean 12 years).Results:47 bone masses was involved of 33 cases,of which 18 cases(26 bones)were in phalanx bone,9(14 bones)in metatarsal bone,4(5 bones)in cuneiform bone, 1(1 bone)in cuboid bone, 1(1 bone)in calcaneus. X-ray findings:patch flake dissolution present in 17 cases(22 bones); patch plaque dissolution and no residual bone in dissolving zone in 6 cases(10 bones); 4(9 bones)more cystic dissolution; 3(3 bones)”shave lead pen sampies”in the one end dissolution of backbone; 3(3 bones)“drawing pin sign” of part dissolution and disappeared of backbone and almost normal of bone in joint end; no sclerosis and no periosteal proliferation and no thickening of bone cortex in dissolution edge of bone, and no sequestrum in dissolving zone; 8 multiple pneumatosis in swollen of soft; 5 calcification of patch flake in soft.Conclusion:X-ray the diabetic osteolysis features patch flake and patch plaque and more cystic of dissolution, no sclerosis and no periosteal proliferation and no sequestrum.

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