锁骨良性溶骨性病变的诊断难题——我们对37例患者的经验
A diagnostic dilema in benign lytic lesions of clavicle - our experience of 37 patients.
作者信息
Baruah Tankeswar, Prakash Jatin, Mehtani Anil, Dev Harvinder, Chopra Rajesh Kumar
机构信息
Central Institute of Orthopaedics, Safderjung Hospital and VMMC, Delhi, 29, India.
Department of Orthopaedics, Lady Hardinge Medical College, Shaheed Bhagat Singh Marg, 110002, New Delhi, India.
出版信息
J Clin Orthop Trauma. 2019 Nov-Dec;10(6):1038-1045. doi: 10.1016/j.jcot.2017.06.023. Epub 2019 Oct 14.
INTRODUCTION
The studies on benign lytic lesion of clavicle are sparse. Asymptomatic nature of lesions, rare occurrence, the difficulty in interpretation of the X-rays because of the surrounding structures and striking similarities in various lesions further make the diagnosis of such atraumatic lytic lesions difficult.
MATERIAL AND METHODS
Prompted by the rarity of lesion and scarcity of data regarding presentation and management, we performed a prospective study of benign lytic lesions of clavicle. The results of the lesions are categorised in infective, metabolic and neoplastic conditions.
RESULTS
Infective lesions were most common cause of symptomatic painful benign lytic lesions. Metabolic lesions, like rickets, were the most common cause of painless swelling in clavicle. Neoplastic conditions although rare were an important differential.
CONCLUSION
It is important to differentiate and diagnose lytic lesions of clavicle. Early MRI and Biopsy of the lesion helps in preventing an undue delay in diagnosis. Most lesions when diagnosed in time have excellent results.
引言
关于锁骨良性溶骨性病变的研究较为稀少。病变的无症状性质、罕见性、由于周围结构导致的X线解读困难以及各种病变之间显著的相似性，进一步增加了此类非创伤性溶骨性病变诊断的难度。
材料与方法
鉴于病变的罕见性以及关于其表现和处理的数据稀缺，我们对锁骨良性溶骨性病变进行了一项前瞻性研究。病变结果分为感染性、代谢性和肿瘤性情况。
结果
感染性病变是有症状的疼痛性良性溶骨性病变最常见的原因。代谢性病变，如佝偻病，是锁骨无痛性肿胀最常见的原因。肿瘤性情况虽然罕见，但却是重要的鉴别诊断对象。
结论
区分和诊断锁骨溶骨性病变很重要。早期进行病变的MRI检查和活检有助于避免诊断的过度延迟。大多数病变若能及时诊断，会有很好的结果。
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