Salimi Z, Vas W, Sundaram M
Department of Radiology, St. Louis University Medical Center, Missouri 63104.
Skeletal Radiol. 1988;17(5):353-5. doi: 10.1007/BF00367182.
Hip pain due to aseptic necrosis of the femoral head was the first clinical manifestation of chronic myelogenous leukemia in a 9-year-old white female. An erroneous diagnosis of rheumatoid arthritis was first entertained. Physical examination showed splenomegaly, complete blood count revealed leucocytosis of 359,000. The initial radiograph of the involved hip was negative. Biopsy revealed aseptic necrosis of the femoral head. Chronic myelogenous leukemia (CML) was diagnosed on the basis of the peripheral blood smear and bone marrow biopsy. Two months later, radiograph, radionuclide bone scan, and magnetic resonance imaging (MR) of the involved hip were positive for aseptic necrosis of the femoral head.
一名9岁白人女性因股骨头无菌性坏死导致髋部疼痛，这是慢性粒细胞白血病的首个临床表现。最初考虑为类风湿关节炎的错误诊断。体格检查发现脾肿大，全血细胞计数显示白细胞增多至359,000。受累髋关节的最初X线片结果为阴性。活检显示股骨头无菌性坏死。根据外周血涂片和骨髓活检诊断为慢性粒细胞白血病。两个月后，受累髋关节的X线片、放射性核素骨扫描和磁共振成像（MR）显示股骨头无菌性坏死呈阳性。
