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以L5神经根病为表现的骨关节炎膝关节孤立性近端腓骨应力性骨折

Isolated Proximal Fibular Stress Fracture In Osteoarthritis Knee Presenting As L5 Radiculopathy.

作者信息

Manish K Kothari, Agnivesh Tikoo, Pramod P Saini, Samir S Dalvie

机构信息

Department of Spine, Hinduja Healthcare Surgical, Mumbai. Maharashtra. India. /

Department of Spine, P D Hinduja National Hospital & MRC, Mahim, Mumbai. Maharashtra. India.

出版信息

J Orthop Case Rep. 2015 Jul-Sep;5(3):75-7. doi: 10.13107/jocr.2250-0685.315.

DOI:10.13107/jocr.2250-0685.315
PMID:27299077
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4719410/
Abstract

INTRODUCTION

Isolated proximal fibular stress fractures are rare and usually seen only in athletes and military recruits. Its occurrence with osteoarthritis of the knee is not documented. Diagnosis of stress fractures is not difficult, but they can mimic other pathologies at times.

CASE REPORT

A 45-year-old male patient presented with pain and paresthesias in left lower thigh and leg. He was previously treated as L5 radiculopathy confirmed with lumbar spine magnetic resonance imaging (MRI). He received analgesics followed by nerve root blocks at another center. He was referred to our center for L4-5 root decompression. Due to atypical spine symptoms, leg radiographs and MRI was done, which showed isolated stress fracture of the left proximal fibula.

CONCLUSION

We conclude that isolated stress fractures of the proximal fibula can present as L5 radiculopathy. A high level of suspicion is required for diagnosis. MRI is the investigation of choice when in doubt.

摘要

引言

孤立性近端腓骨应力性骨折较为罕见，通常仅见于运动员和新兵。其与膝关节骨关节炎同时发生的情况尚无文献记载。应力性骨折的诊断并不困难，但有时可能会与其他病症相混淆。

病例报告

一名45岁男性患者出现左大腿和小腿疼痛及感觉异常。他之前被诊断为L5神经根病，经腰椎磁共振成像（MRI）证实。他在另一家中心接受了镇痛药治疗，随后进行了神经根阻滞。他因L4 - 5神经根减压被转诊至我们中心。由于脊柱症状不典型，进行了腿部X线片和MRI检查，结果显示左近端腓骨孤立性应力性骨折。

结论

我们得出结论，近端腓骨孤立性应力性骨折可表现为L5神经根病。诊断需要高度怀疑。存疑时，MRI是首选的检查方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f91/4719410/ec5769f5cecc/JOCR-5-75-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f91/4719410/3853f6c7ee73/JOCR-5-75-g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f91/4719410/d4e51c1dbc9f/JOCR-5-75-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f91/4719410/ec5769f5cecc/JOCR-5-75-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f91/4719410/3853f6c7ee73/JOCR-5-75-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f91/4719410/b326abd66b93/JOCR-5-75-g002.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f91/4719410/ec5769f5cecc/JOCR-5-75-g007.jpg

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Tibial stress fracture simulate osteomyelitic foci in the course of chronic recurrent multifocal osteomyelitis.在慢性复发性多灶性骨髓炎病程中，胫骨应力性骨折可模拟骨髓炎病灶。
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