Huzjan R, Vukelic-Markovic M, Brkljacic B, Ivanac G
Department of Radiology, University Hospital "Dubrava", Zagreb, Croatia.
Ultraschall Med. 2005 Oct;26(5):420-3. doi: 10.1055/s-2005-857887.
Fibrous cortical defects are local disturbances of ossification, most commonly seen in the metaphysis of tubular bones in growing children. These lesions are usually clinically silent, and most of them heal by being replaced with normal bone. Along with typical age, location and absence of clinical symptoms, plain radiographic films allow the diagnosis of fibrous cortical defect to be made. Because of rare but occasionally occurring complications, follow-up examinations are necessary. In a child with fibrous cortical defect the ultrasound examination demonstrated that fibrous cortical defects display a rather typical sonographic image. One finds clearly delineated defects of the bone located in the vicinity of the knee joint, filled with hypo-echogenic soft tissue, also displaying prominent internal vascularisation on colour-Doppler. We followed this patient up with repeated US examinations revealing the lesions to be shrinking in size and becoming shallower. Echogenic foci within the lesions appeared. It could be presumed that these changes represent the healing process and are comparable to the areas of sclerosis seen on CT scans. We believe that ultrasound with all its benefits is a powerful complementary method for the diagnosis and follow-up of fibrous cortical defects in children.
纤维性骨皮质缺损是一种局部骨化紊乱，最常见于生长中儿童管状骨的干骺端。这些病变通常在临床上无明显症状，且大多数通过被正常骨替代而愈合。结合典型的年龄、部位以及无临床症状，X线平片即可诊断纤维性骨皮质缺损。由于存在罕见但偶尔发生的并发症，随访检查是必要的。在一名患有纤维性骨皮质缺损的儿童中，超声检查显示纤维性骨皮质缺损呈现出相当典型的超声图像。可以清晰地发现位于膝关节附近的骨缺损，内部填充低回声软组织，彩色多普勒显示内部血管丰富。我们对该患者进行了多次超声随访检查，发现病变尺寸缩小且变浅。病变内出现了回声增强灶。可以推测这些变化代表愈合过程，类似于CT扫描上所见的硬化区域。我们认为，具备诸多优势的超声是儿童纤维性骨皮质缺损诊断和随访的有力辅助方法。
