Pal Chandra Prakash, Kumar Harish, Kumar Suneel, Hussain Asif
Department of Orthopaedics, S N Medical College, Agra, Uttar Pradesh, India.
BMJ Case Rep. 2016 Jan 14;2016:bcr2015213636. doi: 10.1136/bcr-2015-213636.
An elderly women with a chronic history of pain and swelling of the right clavicle was investigated. She also had constitutional symptoms. Clinical examination showed mild inflammatory signs over the lateral one-third of the clavicle and the swelling was hard. Clavicle X-ray showed a lytic lesion in the lateral-third of the clavicle and MRI revealed a focal hyperintense area with cortical breach involving the superior cortex of the clavicle. The diagnosis was confirmed as tubercular osteomyelitis after the biopsy, which showed chronic granulomatous inflammation, and the culture was positive for Mycobacterium tuberculosis. Pain resolved by 6 weeks, swelling by 4 months and complete radiological resolution was seen at 15 months after the initiation of antitubercular therapy. No deficit in function was seen. No relapse was noted at 1-year follow-up.
对一位有右锁骨疼痛和肿胀慢性病史的老年女性进行了检查。她还有全身症状。临床检查显示锁骨外侧三分之一处有轻度炎症迹象，肿胀质地坚硬。锁骨X线显示锁骨外侧三分之一处有溶骨性病变，MRI显示有一个局灶性高信号区，皮质破坏累及锁骨上皮质。活检显示为慢性肉芽肿性炎症，培养结果为结核分枝杆菌阳性，确诊为结核性骨髓炎。抗结核治疗开始后6周疼痛缓解，4个月肿胀消退，15个月时影像学完全恢复。未发现功能缺陷。1年随访未发现复发。
