Davies A M, Evans N S, Struthers G R
Department of Radiology, Royal Orthopaedic Hospital, Northfield, Birmingham.
Br J Radiol. 1988 Feb;61(722):103-8. doi: 10.1259/0007-1285-61-722-103.
Eleven post-menopausal women presenting with a parasymphyseal insufficiency fracture of the pubis are reported. The plain radiographs showed delayed healing with a mixed lytic and sclerotic area developed at the fracture site simulating a malignant lesion. Aetiological factors included post-menopausal osteoporosis, rheumatoid arthritis and steroid therapy, previous hip replacement and pelvic radiotherapy. Ten patients had concomitant fractures of the pelvis, including nine with sacral fractures. These were all initially missed on presentation because of the subtle radiographic signs of a longitudinal band of sclerosis, usually bilaterally, in the sacral ala. Bone scanning was shown to be the most sensitive technique in detecting the sacral fractures by demonstrating increased uptake in the sacral ala as well as the other fractures of the pelvis. Computed tomography in three cases was helpful in confirming the presence of fractures and excluding the possibility of malignancy.
本文报告了11例绝经后耻骨联合旁不全骨折的女性患者。X线平片显示骨折愈合延迟，骨折部位出现溶骨与硬化混合区域，类似恶性病变。病因包括绝经后骨质疏松、类风湿关节炎、类固醇治疗、既往髋关节置换及盆腔放疗。10例患者合并骨盆骨折，其中9例为骶骨骨折。由于骶骨翼通常双侧出现的细微纵向硬化带影像学征象，这些骶骨骨折在初诊时均被漏诊。骨扫描显示是检测骶骨骨折最敏感的技术，可显示骶骨翼以及骨盆其他骨折部位放射性摄取增加。3例患者的计算机断层扫描有助于确诊骨折并排除恶性肿瘤的可能性。
