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一例罕见病例报告:与大量饮酒所致股骨头坏死相关的髂腰肌囊实性肿块增大

A rare case report: enlarged iliopsoas cystic solid mass associated with femoral head necrosis induced by heavy alcohol consumption.

作者信息

Li Chen, Liu He, Wang Chenyu, Han Qing, Wang Zhonghan, Qin Yanguo, Wang Jincheng, Yu Tao

机构信息

Department of Orthopedics, The Second Hospital of Jilin University, Changchun, China Hallym University 1Hallymdaehak-gil, Chuncheon, Gangwon-do, Korea.

出版信息

Medicine (Baltimore). 2017 Jun;96(26):e7341. doi: 10.1097/MD.0000000000007341.

Abstract

RATIONALE

This article presents an unusual case of a large iliopsoas cystic solid mass associated with femoral head necrosis in a patient with heavy alcohol consumption for years.

PATIENT CONCERNS

The patient reported pain and limitation of movement at the right hip for 4 months. A soft tissue mass can be palpated deep in the groin several days after the onset of pain.

DIAGNOSES

The laboratory assessments indicated an inflammatory response of the patient. Imaging was performed on the femoral head and iliopsoas cyst. The pathological feature of the mass was evaluated through biopsy examination. It was found that iliopsoas cystic solid mass is secondary to the femoral head necrosis induced by heavy alcohol consumption.

INTERVENTIONS

The patient underwent elective total hip arthroplasty. The bursa was excised and the anterior hip capsule closure was performed.

OUTCOMES

After the surgery, imaging results showed a well-positioned prosthesis. At 1-year follow-up, the prosthesis was still well-positioned and no signs of recurrence of iliopsoas bursa were found.

LESSONS

We suggested the performance of elective total hip arthroplasty, bursa excision, and closure of the anterior hip capsule in patients with femoral necrosis and iliopsoas bursitis presented simultaneously.

摘要

原理

本文介绍了一例不寻常的病例,一名多年酗酒患者出现了与股骨头坏死相关的巨大髂腰肌囊实性肿块。

患者关注

患者自述右髋疼痛及活动受限4个月。疼痛发作数天后,腹股沟深处可触及一软组织肿块。

诊断

实验室评估显示患者有炎症反应。对股骨头和髂腰肌囊肿进行了影像学检查。通过活检检查评估了肿块的病理特征。发现髂腰肌囊实性肿块继发于酗酒引起的股骨头坏死。

干预措施

患者接受了择期全髋关节置换术。切除了滑囊并进行了髋关节前囊闭合术。

结果

术后影像学结果显示假体位置良好。在1年的随访中,假体位置仍然良好,未发现髂腰肌滑囊复发迹象。

经验教训

我们建议对同时出现股骨头坏死和髂腰肌滑囊炎的患者进行择期全髋关节置换术、滑囊切除术和髋关节前囊闭合术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fde/5500071/a51e7752a1dd/medi-96-e7341-g001.jpg

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