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腰椎感染通过腰大肌脓肿蔓延至骨关节炎性髋关节。

Extension of lumbar spine infection into osteoarthritic hip through psoas abscess.

作者信息

Kumagai Kousuke, Ushiyama Toshio, Kawasaki Taku, Matsusue Yoshitaka

机构信息

Department of Orthopedic Surgery, Shiga University of Medical Science, Seta, Otsu, 520-2192, Japan.

出版信息

J Orthop Sci. 2005;10(1):91-4. doi: 10.1007/s00776-004-0847-7.

Abstract

We present a case of pyogenic lumbar discitis and septic hip arthritis, accompanied by a psoas abscess and pyogenic iliopsoas bursitis, for which the correct diagnosis was delayed. The patho-mechanism was speculated to be initial hematogenous infection in the lumbar spine that spread along the psoas muscle as a psoas abscess and then extended into the hip joint via the iliopsoas bursa. For an early correct diagnosis, clinicians should be aware that the lumbar spine and hip joint regions communicate through the psoas muscle space and iliopsoas bursa, making it possible for infection to spread.

摘要

我们报告一例化脓性腰椎间盘炎合并化脓性髋关节炎病例,同时伴有腰大肌脓肿和化脓性髂腰肌滑囊炎,其正确诊断被延误。推测其病理机制为腰椎最初的血源性感染,沿腰大肌扩散形成腰大肌脓肿,然后经髂腰肌滑囊蔓延至髋关节。为实现早期正确诊断,临床医生应意识到腰椎和髋关节区域通过腰大肌间隙和髂腰肌滑囊相通,这使得感染有可能扩散。

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