一名21岁整脊治疗患者的拇指骨髓炎：病例报告
Osteomyelitis of the Thumb in a 21-Year-Old Chiropractic Patient: A Case Report.
作者信息
Bechert Richard E, Guebert Gary M
机构信息
Victory Health, Guntersville, Alabama.
Department of Radiology, Logan University, Chesterfield, Missouri.
出版信息
J Chiropr Med. 2018 Sep;17(3):201-205. doi: 10.1016/j.jcm.2017.10.009. Epub 2018 Aug 28.
OBJECTIVE
The purpose of this case report is to describe the presentation of a patient with osteomyelitis of the thumb.
CLINICAL FEATURES
A 21-year-old man presented with painful, red, and edematous thumb pain over the anterior and posterior surface for a duration of 4 days. The patient reported no trauma or recent operation. The patient was treated conservatively for capsulitis. The patient's symptoms worsened within 2 days, and he was referred for additional imaging consisting of a bone scan. The bone scan showed increased uptake, resulting in a change of diagnosis to suspected osteomyelitis. The patient was referred to a medical doctor for care that consisted of antibiotics and physiotherapy.
INTERVENTION AND OUTCOME
Despite treatment, the patient had some mild permanent damage to the range of motion of the joint and soft tissue volume loss.
CONCLUSION
This case demonstrates the importance of considering osteomyelitis as a differential diagnosis. Amputation was avoided for this patient because of the early recognition and referral.
目的
本病例报告旨在描述一名患有拇指骨髓炎患者的临床表现。
临床特征
一名21岁男性，拇指前后表面出现疼痛、红肿，持续4天。患者自述无外伤史或近期手术史。该患者曾因关节囊炎接受保守治疗。2天内患者症状加重，遂转诊进行包括骨扫描在内的进一步影像学检查。骨扫描显示摄取增加，诊断改为疑似骨髓炎。该患者被转诊至内科医生处，接受抗生素和物理治疗。
干预与结果
尽管进行了治疗，患者关节活动范围仍有一些轻度永久性损伤，软组织体积减少。
结论
本病例表明将骨髓炎作为鉴别诊断的重要性。由于早期识别和转诊，该患者避免了截肢。
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