Iwanowska Beata, Brągoszewska Hanna, Mądzik Jarosław, Szkudlińska-Pawlak Sylwia, Kopyś-Wiszniewska Izabela, Jastrzębska Małgorzata, Kowalska Barbara, Uliasz Maria, Bekiesińska-Figatowska Monika
Department of Diagnostic Imaging, Institute of Mother and Child, Warsaw, Poland.
Pol J Radiol. 2017 Apr 22;82:227-232. doi: 10.12659/PJR.900644. eCollection 2017.
Tumors of the developmental age are an important problem in clinical practice. Primary bone tumors constitute 1-1.5% of all tumors, and 7% of all tumors diagnosed in the developmental age. The aim of the study was to assess the capabilities of imaging methods in diagnosing complications of limb endoprostheses in children with osteoarticular tumors.
MATERIAL/METHODS: We included 155 patients with limb endoprostheses, aged 7-26 years. There were 113 patients with knee prostheses, 1 patient with bilateral knee prostheses, 16 patients with shoulder prostheses, 14 patients with hip prostheses, 11 patients with hip and knee prostheses, and 1 patient with a femoral prosthesis. All patients underwent plain radiography and an ultrasound study.
Complications were found in 50 patients (32% of all patients). The following complications were seen - inflammatory changes in soft tissues and bones (12 patients, 7.7%), stump fractures (11 patients, 7%), lack of elongation effect or shortening of the prosthesis (7 patients, 4.5%), prosthesis fractures (4 patients, 2.5%), crural fractures (4 patients, 2.5%), loosening of the prosthesis (3 patients, 1.9%), joint dislocation (2 patients, 1.3%), stump and prosthesis fracture (1 patient, 0.6%) and local recurrence (6 patients, 3.9%). Prostheses were exchanged for the following reasons - fractures (5 patients, 3.2%), inflammation (2 patients with 3 exchanges, 1.9%). Local recurrence and inflammation were confirmed by a biopsy.
Radiography and ultrasonography are of crucial importance in monitoring patients after implantation of limb endoprostheses. The findings did not require confirmation in additional studies: CT and MRI. Suspicion of local recurrence and inflammation required a biopsy confirmation.
发育年龄阶段的肿瘤是临床实践中的一个重要问题。原发性骨肿瘤占所有肿瘤的1 - 1.5%，在发育年龄阶段诊断出的所有肿瘤中占7%。本研究的目的是评估成像方法在诊断骨与关节肿瘤患儿肢体假体并发症方面的能力。
材料/方法：我们纳入了155例年龄在7 - 26岁的肢体假体患者。其中有113例膝关节假体患者，1例双侧膝关节假体患者，16例肩关节假体患者，14例髋关节假体患者，11例髋关节和膝关节假体患者，以及1例股骨假体患者。所有患者均接受了X线平片和超声检查。
50例患者（占所有患者的32%）发现有并发症。观察到以下并发症——软组织和骨骼的炎症改变（12例患者，7.7%）、残端骨折（11例患者，7%）、假体无延长效应或缩短（7例患者，4.5%）、假体骨折（4例患者，2.5%）、小腿骨折（4例患者，2.5%）、假体松动（3例患者，1.9%）、关节脱位（2例患者，1.3%）、残端和假体骨折（1例患者，0.6%）以及局部复发（6例患者，3.9%）。更换假体的原因如下——骨折（5例患者，3.2%）、炎症（2例患者进行了3次更换，1.9%）。局部复发和炎症通过活检得到证实。
X线摄影和超声检查在肢体假体植入后监测患者方面至关重要。这些发现无需在额外的CT和MRI研究中得到证实。怀疑局部复发和炎症需要活检证实。
