Solomon Michael, Stening Michael, Macdessi Samuel, Shearman Christine, Pereira John, Hiew Chee Chung, Van der Wall Hans
Department of Pediatric Orthopedics, Sydney Children's Hospital, New South Wales, Australia.
Australas Radiol. 2003 Jun;47(2):181-3. doi: 10.1046/j.0004-8461.2003.01148.x.
Two male children presented with increasing pain in the right knee and constitutional symptoms. Biochemical markers of inflammation were elevated. Plain radiography was reported as normal and bone scintigraphy was consistent with synovitis of the right knee in the first case. The second child underwent aspiration of the knee with drainage of turbid fluid 1 week after antibiotics. Slow response to therapy led to MRI and CT scanning in the second child, revealing an epiphyseal abscess. Review of the scintigraphic studies in the first child raised the possibility of osteomyelitis of the distal right femur. Further imaging was undertaken with MRI and CT scanning confirming an epiphyseal bone abscess. Failure of diagnosis of an epiphyseal bone abscess by combined plain radiography and scintigraphy has not previously been reported and provides a number of valuable lessons.
两名男童出现右膝疼痛加剧及全身症状。炎症生化指标升高。X线平片报告正常，骨扫描在第一例中与右膝滑膜炎相符。第二名儿童在使用抗生素1周后进行了膝关节穿刺，抽出浑浊液体。治疗反应缓慢导致第二名儿童进行了MRI和CT扫描，发现骨骺脓肿。对第一名儿童的骨扫描研究回顾提示右股骨远端骨髓炎的可能性。进一步进行了MRI和CT扫描，证实为骨骺骨脓肿。此前尚未有关于通过X线平片和骨扫描联合诊断骨骺骨脓肿失败的报道，这提供了一些宝贵的经验教训。
