Andreacchio Antonio, Marengo Lorenza, Canavese Federico
Antonio Andreacchio, Lorenza Marengo, Department of Pediatric Orthopedic Surgery, Regina Margherita Children's Hospital, 10100 Torino, Italy.
World J Orthop. 2016 Aug 18;7(8):494-500. doi: 10.5312/wjo.v7.i8.494.
To confirm the rarity of this disorder and then to evaluate the effects of antibiotic treatment alone and assess whether this could produce a complete remission of symptoms in children and adolescents.
We made a retrospective review of all cases of condensing osteitis of the clavicle in children and adolescents between January 2007 and January 2016. Outpatient and inpatient medical records, with radiographs, magnetic resonance imaging, triphasic bone scan and computed tomography scans were retrospectively reviewed. All the patients underwent biopsy of the affected clavicle and were treated with intra venous (IV) antibiotics followed by oral antibiotics.
Seven cases of condensing osteitis of the clavicle were identified. All the patients presented with swelling of the medial end of the clavicle, and 5 out of 7 reported persisting pain. The patients' mean age at presentation was 11.5 years (range 10.5-13). Biopsy confirmed the diagnosis in all cases. All the patients completed the treatment with IV and oral antibiotics. At last follow-up visit none of the patients complained of residual pain; all had a clinically evident reduction in the swelling of the medial end of the affected clavicle. The mean follow-up was 4 years (range 2-7).
Our findings show that condensing osteitis of the clavicle is a rare condition. Biopsy is needed to confirm diagnosis. The condition should be managed with IV and oral antibiotics. Aggressive surgery should be avoided.
确认这种疾病的罕见性,然后评估单纯抗生素治疗的效果,并评估其是否能使儿童和青少年的症状完全缓解。
我们对2007年1月至2016年1月期间儿童和青少年锁骨致密性骨炎的所有病例进行了回顾性研究。回顾了门诊和住院病历,以及X光片、磁共振成像、三相骨扫描和计算机断层扫描。所有患者均接受了患侧锁骨活检,并先接受静脉抗生素治疗,随后口服抗生素。
共确诊7例锁骨致密性骨炎。所有患者均表现为锁骨内侧端肿胀,7例中有5例报告持续疼痛。患者就诊时的平均年龄为11.5岁(范围10.5 - 13岁)。活检在所有病例中均确诊。所有患者均完成了静脉和口服抗生素治疗。在最后一次随访时,没有患者抱怨残留疼痛;所有患者患侧锁骨内侧端肿胀在临床上均有明显减轻。平均随访时间为4年(范围2 - 7年)。
我们的研究结果表明,锁骨致密性骨炎是一种罕见疾病。需要活检来确诊。该病应采用静脉和口服抗生素治疗。应避免激进的手术。