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[成骨不全症的放射学]

[The radiology of osteogenesis imperfecta].

作者信息

Orzincolo C, Castaldi G, Scutellari P N, Ghedini M, Franceschini F, Bagni B

机构信息

Servizio di Radiologia, Arcispedale S. Anna, Ferrara.

出版信息

Radiol Med. 1992 Nov;84(5):557-66.

PMID:1475419
Abstract

The term "osteogenesis imperfecta" refers to a heterogeneous group of hereditary diseases characterized by osteopenia, increased bone fragility, blue sclerae and dentinogenesis imperfecta. The abnormal synthesis of type-I collagen is responsible for the pathologic changes occurring not only in bone, but also in skin, tendons and ligaments, sclerae and teeth. The clinical and radiographic features of 5 cases (2 males and 3 females; age range: 1 month to 29 years) were analyzed. The patients were unrelated with each other. The diagnosis of the different types of osteogenesis imperfecta is as difficult as the identification of the various genotypes which are responsible for the different clinical pictures. The most characteristic radiographic pattern--which is observed in any type of the disease--consists in osteopenia associated, in most cases, with multiple fractures and deformities--e.g., micromelia, large metaphysis, archon long bones. Typically, "pop corn" calcifications are observed in both epiphysis and metaphysis of long bones. Dentinogenesis imperfecta is one of the most significant clinical patterns, and it can be the only bone abnormality. The prognosis of osteogenesis imperfecta is as varied as its genetics--i.e., the fractures discovered at birth are not necessarily a negative prognostic sign.

摘要

“成骨不全症”一词指的是一组遗传性疾病,其特征为骨质减少、骨脆性增加、巩膜发蓝和牙本质发育不全。I型胶原蛋白的异常合成不仅导致骨骼出现病理变化,还会影响皮肤、肌腱和韧带、巩膜及牙齿。对5例患者(2例男性,3例女性;年龄范围:1个月至29岁)的临床和影像学特征进行了分析。这些患者之间无亲缘关系。不同类型成骨不全症的诊断与确定导致不同临床表现的各种基因型一样困难。在任何类型的该疾病中都能观察到的最具特征性的影像学表现为骨质减少,在大多数情况下还伴有多处骨折和畸形,例如四肢短小、干骺端增大、长骨弓形。典型的是,在长骨的骨骺和干骺端均观察到“爆米花”样钙化。牙本质发育不全是最显著的临床症状之一,并且可能是唯一的骨骼异常。成骨不全症的预后与其遗传学一样多样,即出生时发现的骨折不一定是不良预后的标志。

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