Piepenburg R, Doll G, Grimm J, Hahn K
Klinik für Nuklearmedizin, Johannes-Gutenberg-Universität Mainz, FRG.
Nuklearmedizin. 1992 Dec;31(6):225-9.
Aseptic bone necrosis in adults is usually caused by circulation defects or metabolic diseases but may also occur without any obvious reason. In these "idiopathic" cases, alcoholism seems to play a prominent role. In addition to the frequently affected femoral heads other bones may be involved. Here a remarkable pattern of localizations is reported: the bilateral idiopathic necroses of the heads of both humerus and femur. Untreated aseptic bone necroses close to a joint commonly leads to severe secondary arthrosis and destruction of the joint within a short time. Therefore, only a diagnosis in an early stage of the disease offers the chance of a successful joint-preserving therapy. In cases of clinically suspected aseptic bone necrosis but still negative or doubtful X-ray findings, bone scans or MRI are reliable methods of verifying the diagnosis.
成人无菌性骨坏死通常由循环缺陷或代谢疾病引起，但也可能无明显原因发生。在这些“特发性”病例中，酗酒似乎起了重要作用。除了股骨头经常受累外，其他骨骼也可能受累。本文报道了一种显著的定位模式：双侧肱骨和股骨头特发性坏死。靠近关节的未经治疗的无菌性骨坏死通常会在短时间内导致严重的继发性关节炎和关节破坏。因此，只有在疾病早期进行诊断才有机会成功进行保留关节的治疗。在临床怀疑为无菌性骨坏死但X线检查结果仍为阴性或可疑的情况下，骨扫描或磁共振成像（MRI）是验证诊断的可靠方法。
