Bradleigh L H, Perkash A, Linder S H, Sullivan G H, Bhatt H K, Perkash I
Spinal Cord Injury Service, Palo Alto Veterans Administration Medical Center, CA 94304.
Arch Phys Med Rehabil. 1992 Mar;73(3):293-4.
The differential diagnosis of the swollen lower extremity in the patient with spinal cord injury includes deep venous thrombosis, fracture, cellulitis, joint sepsis, heterotopic ossification, hematoma formation, and neoplasm. A patient with an asymmetrically swollen limb who was found to have concurrent ipsilateral acute deep venous thrombosis and active heterotopic ossification is described. The diagnostic workup included various laboratory and radiologic studies. Therapy included anticoagulation with heparin and warfarin. To treat the heterotopic ossification, indomethacin, etidronate, and graded range of motion were used. We learned from this patient and several similar cases that acute deep-venous thrombosis and active heterotopic ossification may occur concurrently, and therapeutic anticoagulation did not lead to bleeding within or around the area of active heterotopic ossification. The possibility of a relationship between heterotopic ossification and deep venous thrombosis is presently being studied at our institution.
脊髓损伤患者下肢肿胀的鉴别诊断包括深静脉血栓形成、骨折、蜂窝织炎、关节脓毒症、异位骨化、血肿形成和肿瘤。本文描述了一名肢体不对称肿胀的患者，该患者同时被发现患有同侧急性深静脉血栓形成和活跃的异位骨化。诊断检查包括各种实验室和影像学研究。治疗包括使用肝素和华法林进行抗凝。为了治疗异位骨化，使用了吲哚美辛、依替膦酸和分级活动范围训练。我们从该患者及几例类似病例中了解到，急性深静脉血栓形成和活跃的异位骨化可能同时发生，且治疗性抗凝并未导致活跃异位骨化区域内或其周围出血。目前我们机构正在研究异位骨化与深静脉血栓形成之间关系的可能性。
