Englaro E E, Gelfand M J, Paltiel H J
Department of Radiology, Children's Hospital Medical Center, Cincinnati, Ohio 45229-2899.
J Nucl Med. 1992 Mar;33(3):351-4.
Small children often cannot describe the location of bone pain for parents or physicians. Bone scans were performed in 56 children under five years of age with lower extremity pain and/or gait abnormalities of unknown etiology. Patients with fever, and those known to have infection, child abuse, malignancy, and/or radiographic abnormalities were excluded. Thirty patients had abnormal bone scans. Abnormalities included evidence of hip synovitis (4), femoral head avascularity (2), various proximal femoral abnormalities (3), knee synovitis (3), toddler's fracture (1), various tibial or fibular abnormalities (4), and various abnormalities of the tarsal bones (16). Tarsal bone abnormalities included four with abnormal calcaneal uptake and nine with abnormal uptake in or adjacent to the cuboid bone. Correlative imaging studies were available for 26 sites, and focal bone findings were noted at only five locations. Tarsal bone abnormalities accounted for over half of the scintigraphic abnormalities in these preschool children with gait abnormalities. Abnormal uptake in/or adjacent to the cuboid bone was common and probably represented stress injury.
幼儿往往无法向父母或医生描述骨痛的位置。对56名5岁以下出现下肢疼痛和/或病因不明的步态异常的儿童进行了骨扫描。排除了发热患者以及已知患有感染、虐待儿童、恶性肿瘤和/或影像学异常的患者。30名患者的骨扫描结果异常。异常情况包括髋关节滑膜炎（4例）、股骨头缺血性坏死（2例）、各种股骨近端异常（3例）、膝关节滑膜炎（3例）、幼儿骨折（1例）、各种胫骨或腓骨异常（4例）以及跗骨的各种异常（16例）。跗骨异常包括4例跟骨摄取异常和9例骰骨或其邻近部位摄取异常。对26个部位进行了相关成像研究，仅在5个位置发现了局灶性骨病变。在这些患有步态异常的学龄前儿童中，跗骨异常占骨闪烁显像异常的一半以上。骰骨或其邻近部位摄取异常很常见，可能代表应力性损伤。
