Kant Kumar Shashi, Agarwal Anil, Suri Tarun, Gupta Neeraj, Verma Indreshwar, Shaharyar Abbas
Senior Resident, Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, India.
Trop Doct. 2014 Jan;44(1):29-32. doi: 10.1177/0049475513512633. Epub 2013 Nov 19.
Our study retrospectively reviewed the presentation, healing response, and functional results of eight cases of unilateral knee tuberculosis in children. The patients were evaluated for pain, instability, deformity, range of motion, and limb length discrepancy. Seven cases presented radiologically with Kerri and Martini's stage 1 or 2 and one in stage 4. Epiphyseal involvement was present in five cases. At final follow-up, all the knees were painless and stable. A full range of motion was recovered in the early stages. Limb length discrepancy was seen in six cases. Radiologically, despite clinical healing, the lytic lesions persisted for longer. Joint space was not reduced in seven cases at the initial presentation which was maintained following treatment. In the early stages, multidrug chemotherapy alone is sufficient and joints should be mobilized early in order to prevent stiffness. The lytic epiphyseal and metaphyseal cavities may persist for several months even after successful treatment. Limb length discrepancy is a common complication of knee tuberculosis in children.
我们的研究回顾性分析了8例儿童单侧膝关节结核的临床表现、愈合反应及功能结果。对患者进行了疼痛、不稳定、畸形、活动范围及肢体长度差异等方面的评估。7例患者的影像学表现为克里和马蒂尼1期或2期,1例为4期。5例存在骨骺受累。末次随访时,所有膝关节均无疼痛且稳定。早期恢复了全范围活动。6例出现肢体长度差异。影像学上,尽管临床愈合,但溶骨性病变持续时间更长。7例患者初次就诊时关节间隙未变窄,治疗后得以维持。早期,仅多药化疗就足够了,应尽早活动关节以防止僵硬。即使治疗成功,溶骨性骨骺和干骺端空洞可能持续数月。肢体长度差异是儿童膝关节结核的常见并发症。