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一名患有硬化性肋骨病变的53岁男性:病例报告。

A 53-year-old man with a sclerosing rib lesion: A case report.

作者信息

Bai Shucai, Zhang Huafeng, Li Zhijun, Li Dong, Li Hui

机构信息

Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China.

出版信息

Medicine (Baltimore). 2017 Nov;96(47):e8692. doi: 10.1097/MD.0000000000008692.

Abstract

RATIONALE

Sclerosing osteomyelitis of Garré is a rare condition that occurs most commonly in tubular bones and the mandible. Its nontypical symptoms, low morbidity, and insidious process make its diagnosis difficult at an early stage. In this article, we reported a case of chronic sclerosing osteomyelitis which occurred in flat bone.

PATIENT CONCERNS

A 53-year-old man was diagnosed with rib sclerosing osteomyelitis of Garré who had an 8-year course of intermittent local pain and swelling, which radiated toward the left side of his chest wall. Chest computed tomography (CT) showed irregular sclerosis of the diaphysis of the 10th rib, with periosteal reaction and narrowing of the medullary cavity, and magnetic resonance imaging (MRI) showed T2 heterogeneous low-signal intensity over the 10th rib.

DIAGNOSES

Based on the features of the clinical signs and radiography and biopsy of the lesion, diagnosis of rib sclerosing osteomyelitis of Garré was made.

INTERVENTIONS

The patient was treated with surgical excision of a 10-cm-long lesion after failed conservative treatment.

OUTCOMES

Postoperatively, the patient achieved good functional recovery at the 10-year follow-up.

LESSONS

Rib sclerosing osteomyelitis of Garré is an unusual condition and represents a noninfective course in the rib with a low morbidity. The surgical management was successful in relieving the patient's symptom.

摘要

理论依据

加雷氏硬化性骨髓炎是一种罕见疾病,最常发生于管状骨和下颌骨。其非典型症状、低发病率以及隐匿的病程使得早期诊断困难。在本文中,我们报告了一例发生于扁骨的慢性硬化性骨髓炎病例。

患者情况

一名53岁男性被诊断为加雷氏肋骨硬化性骨髓炎,有8年间歇性局部疼痛和肿胀病史,疼痛向左胸壁放射。胸部计算机断层扫描(CT)显示第10肋骨骨干不规则硬化,伴有骨膜反应和髓腔狭窄,磁共振成像(MRI)显示第10肋骨T2加权像呈不均匀低信号强度。

诊断

根据临床体征、影像学表现及病变活检结果,诊断为加雷氏肋骨硬化性骨髓炎。

干预措施

保守治疗失败后,对患者进行了手术切除,切除病变长度为10厘米。

结果

术后10年随访时,患者功能恢复良好。

经验教训

加雷氏肋骨硬化性骨髓炎是一种罕见疾病,代表肋骨的非感染性病程,发病率低。手术治疗成功缓解了患者症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb9e/5708949/75750419771e/medi-96-e8692-g002.jpg

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