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肩胛骨质破坏:在流行地区不要忘记考虑结核病。

Scapular bone destruction: do not forget to think of tuberculosis in endemic areas.

作者信息

Sharma Barun Kumar, Singh Varun Kumar, Nishant Kumar, Das Deepak

机构信息

Department of Radiodiagnosis, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India.

出版信息

BMJ Case Rep. 2013 Jul 4;2013:bcr2013200051. doi: 10.1136/bcr-2013-200051.

Abstract

Tuberculosis is an endemic disease of worldwide concern. The most common involvement is in the form of pulmonary tuberculosis. Musculoskeletal system is involved in 20-30% of cases of extrapulmonary tuberculosis. Among these cases of musculoskeletal tuberculosis, vertebral column is most commonly involved followed by long bones. However, tuberculosis of flat bones like scapula is very rare. We present a case of a 56-year-old woman with painless swelling in the right lower back of chest. Ultrasonography suggested abscess formation. A chest X-ray and CT scan suggested coexisting pulmonary tuberculosis. CT revealed abscess with osteomyelitis of inferior angle of scapula. The abscess was aspirated and histopathological examination confirmed tubercular pathology. A 6-month course of antitubercular treatment resulted in complete resolution of symptoms.

摘要

结核病是一种全球关注的地方性疾病。最常见的受累形式是肺结核。骨与肌肉系统受累见于20% - 30%的肺外结核病例。在这些骨与肌肉结核病例中,脊柱最常受累,其次是长骨。然而,像肩胛骨这样的扁骨结核非常罕见。我们报告一例56岁女性,其右胸下背部有无痛性肿胀。超声检查提示脓肿形成。胸部X线和CT扫描提示合并肺结核。CT显示肩胛骨下角有脓肿并伴有骨髓炎。脓肿穿刺,组织病理学检查确诊为结核病变。6个月的抗结核治疗疗程使症状完全缓解。

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