Rasool M N
Department of Orthopaedic Surgery, Nelson R. Mandela School of Medicine, Durban, South Africa.
J Pediatr Orthop. 2001 Nov-Dec;21(6):749-55.
Forty-two children with tuberculous osteomyelitis were seen and treated between 1984 and 1999. The age ranged from 1 to 12 years (average 6); there were 31 boys and 11 girls. There were 50 osseous lesions (excluding spinal and synovial). Five children had multifocal bone involvement. There were four basic types of lesions: cystic (n = 26), infiltrative (n = 10), focal erosions (n = 8), and spina ventosa (n = 6). The majority of the lesions were in the metaphyses (n = 25); the remainder were in the diaphysis, epiphysis, short tubular bones, flat bones, and small round bones. The erythrocyte sedimentation rate was normal in seven, and the Mantoux test was negative in four. Bone lesions resembled pyogenic and fungal infections and benign and malignant bone tumors. Histologic confirmation was obtained in all patients. Curettage and antituberculous treatment yielded good results in the majority of patients, with follow-up of 6 months to 9 years. Biopsy is mandatory to confirm the diagnosis.
1984年至1999年间，共诊治42例结核性骨髓炎患儿。年龄范围为1至12岁（平均6岁）；其中男孩31例，女孩11例。共有50处骨病变（不包括脊柱和滑膜）。5例患儿有多灶性骨受累。有四种基本病变类型：囊性（n = 26）、浸润性（n = 10）、局灶性侵蚀（n = 8）和骨气臌（n = 6）。大多数病变位于干骺端（n = 25）；其余位于骨干、骨骺、短管状骨、扁骨和小圆形骨。7例红细胞沉降率正常，4例结核菌素试验阴性。骨病变类似化脓性和真菌感染以及良性和恶性骨肿瘤。所有患者均获得组织学确诊。刮除术和抗结核治疗在大多数患者中取得了良好效果，随访时间为6个月至9年。必须进行活检以确诊。
