Mikosch Peter, Jauk Barbara, Kaulfersch Wilhelm, Gallowitsch Hans-Jürgen, Lind Peter
Abteilung für Nuklearmedizin und Endokrinologie, Landeskrankenhaus Klagenfurt, St. Veiterstrasse 47, A-9020 Klagenfurt.
Wien Med Wochenschr. 2003;153(3-4):83-8. doi: 10.1046/j.1563-258x.2003.02006.x.
The case of an eight years old African boy who suffers from sickle cell-thalassemia is presented. In the course of the disease frequent pain attacks occurred within the abdomen and extremities, recently also within the trunk. Local pain, at some occasions in combination with local swelling and always positive laboratory parameters for inflammation, hindered a solely clinical differentiation between bone infarcts and osteomyelitis. Bone scintigraphy, eventually in combination with bone marrow scintigraphy, can assist the clinician in the differentiation of aseptic bone infarcts versus secondary osteomyelitis. Based on the presented case scintigraphic results for bone infarcts, osteomyelitis and special scintigraphic pattern seen in sickle cell disease are presented. Furthermore, problems regarding the interpretation of the scintigraphies in relation to the delayed time after the beginning of pain attacks are discussed.
本文介绍了一名患有镰状细胞 - 地中海贫血的8岁非洲男孩的病例。在疾病过程中,腹部和四肢频繁出现疼痛发作,最近躯干也出现疼痛。局部疼痛,有时伴有局部肿胀,且炎症实验室指标始终呈阳性,这使得仅通过临床症状难以区分骨梗死和骨髓炎。骨闪烁显像,最终结合骨髓闪烁显像,可协助临床医生区分无菌性骨梗死和继发性骨髓炎。基于该病例,展示了骨梗死、骨髓炎的闪烁显像结果以及镰状细胞病中所见的特殊闪烁显像模式。此外,还讨论了疼痛发作开始后延迟时间对闪烁显像结果解读的相关问题。