Lee Ho Jun, Kwon Bum Sun, Kwon Jae Hyun, Park Jin Woo, Ryu Ki Hyung, Cha Dong Youn, Shim Jae Hoon, Lim Woo Hyun
Department of Physical Medicine & Rehabilitation, College of Medicine, Dongguk University, Goyang 410-773, Korea.
Ann Rehabil Med. 2012 Apr;36(2):287-90. doi: 10.5535/arm.2012.36.2.287. Epub 2012 Apr 30.
Vascular malformations in extremities are difficult to detect in cases of minor trauma. The authors report a case of an arteriovenous malformation (AVM) incidentally found by ultrasonography in a contusion. After a slip down, a 52-year-old man who had undergone total arthroplasty in both hips 10 years earlier complained of an ovoid right hip swelling that had gradually increased in size. Suspecting a simple cyst or hematoma, the swelling was examined by ultrasonography, which revealed a subcutaneous hematoma with arterial flow connected to muscle. Arteriography revealed an AVM around the right hip joint. Due to the presence of multiple arteriovenous shunts, a conservative treatment course was adopted and after 3 weeks of treatment the swelling almost completely resolved. It appears that the small AVM may have existed congenitally before hip surgery and the contusion over the AVM had led to hematoma rather than an arteriovenous fistula. The authors emphasize the usefulness of ultrasonography for the diagnosis of posttraumatic swelling.
在轻微创伤的情况下，四肢血管畸形很难被检测出来。作者报告了一例在挫伤中通过超声意外发现的动静脉畸形（AVM）病例。一名52岁男性10年前双侧髋关节均接受了全关节置换术，滑倒后，他抱怨右髋部有一个椭圆形肿胀，且肿胀大小逐渐增加。怀疑是单纯囊肿或血肿，遂对肿胀部位进行超声检查，结果显示皮下血肿伴有与肌肉相连的动脉血流。血管造影显示右髋关节周围存在动静脉畸形。由于存在多个动静脉分流，因此采取了保守治疗方案，治疗3周后肿胀几乎完全消退。看来这个小的动静脉畸形可能在髋关节手术前就先天性存在，而动静脉畸形处的挫伤导致了血肿而非动静脉瘘。作者强调了超声在诊断创伤后肿胀方面的实用性。
