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结核性髋关节炎:诊断问题与治疗方法:病例报告

Tuberculous coxitis: diagnostic problems and varieties of treatment: a case report.

作者信息

Klein H, Seeger Jb, Schleicher I

机构信息

Department of Orthopaedics and Orthopaedic Surgery, University Hospital Giessen and Marburg (UKGM), Klinikstraße 33, D-35392 Giessen, Germany.

出版信息

Open Orthop J. 2012;6:445-8. doi: 10.2174/1874325001206010445. Epub 2012 Oct 4.

Abstract

Although the prevalence of tuberculosis reduces, it still belongs to the most important infectious diseases worldwide even in industrial countries.We report an unusual case of tuberculous coxitis in a 28-year-old healthy native female with recurrent hip pain. While X-ray and microbiological examination of the aspirate showed no abnormality, only extended diagnostic measurements and detailed history led to the diagnosis of TBC. Although the patient did not show any pulmonary symptoms open tuberculosis was confirmed. After a course of antibiotic treatment she underwent reconstructive surgery which consecutively improved range of motion. This case report emphasizes that tuberculosis should still be considered as a significant disease even in healthy patients with uncertain complaints in joints without significant initial radiographic abnormalities. We recommend the described diagnostic procedures as well as an antibiotic and surgical treatment.

摘要

尽管结核病的发病率有所下降,但即便在工业化国家,它仍是全球最重要的传染病之一。我们报告了一例罕见的结核性髋关节炎病例,患者为一名28岁健康的本地女性,反复出现髋关节疼痛。虽然抽吸物的X线检查和微生物学检查未显示异常,但只有通过进一步的诊断措施和详细病史才得以诊断出结核病。尽管患者没有任何肺部症状,但确诊为开放性肺结核。经过一个疗程的抗生素治疗后,她接受了重建手术,随后关节活动范围得到改善。本病例报告强调,即使是健康患者,出现关节不明原因不适且初始影像学无明显异常时,仍应将结核病视为一种重大疾病。我们推荐上述诊断程序以及抗生素和手术治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c85/3474948/642ad291269d/TOORTHJ-6-445_F1.jpg

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