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进行性骨化性纤维发育不良:诊断与管理的难点 一例病例报告及文献综述

Fibrodysplasia Ossificans Progressiva: Difficulty in Diagnosis and Management A case report and literature review.

作者信息

Kamal Achmad Fauzi, Novriansyah Robin, Prabowo Yogi, Siregar Nurjati Chairani

机构信息

Department of Orthopaedic and Traumatology, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia.

Department of Anatomical Pathology, Cipto MAngunkusumo Hospital, Faculty of Medicine Universitas Indonesia.

出版信息

J Orthop Case Rep. 2015 Jan-Mar;5(1):26-30. doi: 10.13107/jocr.2250-0685.248.

Abstract

INTRODUCTION

Fibrodysplasia ossificans progressiva (FOP) is a rare autosomal dominant genetic disorder and characterized by postnatal progressive heterotopic ossification of the connective tissue. There are difficulties in diagnosing FOP, thus delayed or misdiagnosis and mismanagement is common. 3D printers have now become widely available and inexpensive, and can be used to rapidly produce life-size models based on CT scans of an individual patient. The availability of patient specific, accurate and detailed models of complex acetabular fractures can aid planning of surgical management on a patient specific basis.

CASE REPORT

We present the diagnosis and surgical management of a 9-year old Indonesian girl with FOP. She presented with extensive involvement of cervical spine and both shoulders. Total excision of occipito-cervico-lumbar and paravertebral ossification and also exostoses at bilateral shoulder was done. At three years follow up, she had local recurrence with similar range of movement of the shoulder and cervical spine.

CONCLUSION

FOP is an extremely rare case. It is difficult to diagnose and manage FOP, therefore delayed or misdiagnosis and also inappropriate management is common.

摘要

引言

进行性骨化性纤维发育不良(FOP)是一种罕见的常染色体显性遗传病,其特征为出生后结缔组织进行性异位骨化。FOP的诊断存在困难,因此延迟诊断、误诊及管理不当的情况很常见。3D打印机现已广泛普及且价格低廉,可用于根据个体患者的CT扫描快速制作实物大小的模型。复杂髋臼骨折的患者特异性、准确且详细的模型有助于基于患者个体情况进行手术管理规划。

病例报告

我们介绍了一名9岁印度尼西亚FOP女童的诊断及手术治疗情况。她表现为颈椎和双肩广泛受累。进行了枕颈胸腰段及椎旁骨化以及双侧肩部外生骨疣的全切术。随访三年时,她出现了局部复发,肩部和颈椎的活动范围类似。

结论

FOP是极为罕见的病例。FOP的诊断和管理都很困难,因此延迟或误诊以及管理不当的情况很常见。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18f0/4719346/594282d8691e/JOCR-5-26-g001.jpg

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