Lai Y C, Hwu W L, Wang T R, Hsieh K H, Lee C Y, Li Y W
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan, R.O.C.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1991 Jul-Aug;32(4):244-50.
An 11-year-old boy with Gaucher disease developed acute bone pain of the left thigh, accompanied by fever and signs of inflammation. Initially he was treated as osteomyelitis with antibiotics. Cultures of blood and aspirate of a subperiosteal hematoma were negative for bacterial growth. Tc99m bone scan revealed relatively decreased uptake over the involved area, and the findings of magnetic resonance imaging were typical for Gaucher crisis. Although Ga 67 imaging was positive, the diagnosis of a bone pain crisis rather than an infection was made. Antibiotics were discontinued without sequelae. Differential diagnosis between Gaucher crisis and osteomyelitis is discussed.
一名患有戈谢病的11岁男孩出现左大腿急性骨痛,并伴有发热和炎症迹象。最初他被当作骨髓炎用抗生素治疗。血液培养和骨膜下血肿穿刺液培养均未发现细菌生长。锝99m骨扫描显示受累区域摄取相对减少,磁共振成像结果为戈谢危象的典型表现。尽管镓67成像呈阳性,但仍诊断为骨痛危象而非感染。停用抗生素后未出现后遗症。文中讨论了戈谢危象与骨髓炎的鉴别诊断。