Rezaie Elisa S, Maas Mario, van der Horst Chantal M A M
Department of Plastic Surgery, Academic Medical Center, Amsterdam, The Netherlands.
BMJ Case Rep. 2018 Mar 27;2018:bcr-2017-223986. doi: 10.1136/bcr-2017-223986.
We present a case of a 67-year-old man with episodes of extreme pain of the right lower extremity that prevented him from walking and sleeping. The patient had a history of varices in both legs. Physical examination showed a pretibial varix of the right leg inferiorly from a painful spot. X-ray of the right lower leg showed a cortex disruption at this spot. MRIs confirmed the disruption of the cortex of the right tibia and demonstrated an intraosseous vessel. The diagnosis intraosseous varices was made and the vein was surgically resected. Follow-up took place after 3 years and the patient was free from any symptoms related to the intraosseous varicose vein. The pathophysiology causing the pain symptoms is hard to understand, partly due to the limited cases presented with such anomalies. We demonstrate our case in the hope to generate more knowledge about this disorder.
我们报告一例67岁男性病例，其右下肢出现剧痛发作，导致无法行走和睡眠。该患者双下肢有静脉曲张病史。体格检查显示，从疼痛部位向下可见右小腿胫前静脉曲张。右小腿X线显示该部位皮质中断。磁共振成像（MRI）证实右胫骨皮质中断，并显示有骨内血管。诊断为骨内静脉曲张，并对该静脉进行了手术切除。3年后进行随访，患者未出现与骨内静脉曲张相关的任何症状。导致疼痛症状的病理生理学机制难以理解，部分原因是此类异常病例较少。我们展示该病例，希望能增加对这种疾病的了解。
