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一例罕见的里宾病——诊断与治疗

A Rare Case of Ribbing Disease- Diagnosis and Management.

作者信息

Lokesh M, Suriyakumar Sundar

机构信息

Department of Orthopedic Surgery, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

出版信息

J Orthop Case Rep. 2020 Jul;10(4):69-73. doi: 10.13107/jocr.2020.v10.i04.1808.

DOI:10.13107/jocr.2020.v10.i04.1808
PMID:33623772
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7885652/
Abstract

INTRODUCTION

Ribbing diseases is rare and have only been occasionally reported. We here in report a case of Ribbing disease affecting bilateral tibia which was diagnosed based on computed tomography (CT), magnetic resonance imaging (MRI), and histopathological features and managed by intramedullary reaming .

CASE REPORT

A 45 - year - old female presented with complaints of pain in the right leg for the past four 4 months duration and the patient had similar complaints of pain in the left leg 3 years back for which she had had taken treatment at an outside hospital where she underwent saucerization of the left tibia as a case of low- grade osteomyelitis . To evaluate the cause of pain X-ray, CT and, MRI were done which were suggestive of Ribbings disease and biopsy was performed which favoured the diagnosis of Ribbings disease. The patient was tried on a course of analgesics , with no symptomatic betterment , after going through the literature, the patient was taken up for the right tibia intramedullary reaming. Post operatively, the patient symptomatically improved and is pain free for the past 4 years.

CONCLUSION

Ribbing disease is an uncommon cause of a common symptom. It is a rare diaphyseal sclerosing dysplasia. With lack of clinical signs of infection and biochemical evidence of metabolic bone disease and positive clinical, radiological and histological features in favour of ribbing disease helped us in arriving at the diagnosis. Intramedullary reaming of the affected bone has been useful in providing symptomatic betterment .

摘要

引言

里宾病较为罕见,仅有零星报道。我们在此报告一例累及双侧胫骨的里宾病病例,该病例通过计算机断层扫描(CT)、磁共振成像(MRI)及组织病理学特征得以确诊,并采用髓内扩孔术进行治疗。

病例报告

一名45岁女性,主诉右腿疼痛4个月。患者3年前左腿也曾有类似疼痛,当时在外院接受治疗,因低度骨髓炎对左胫骨进行了碟形手术。为评估疼痛原因,进行了X线、CT及MRI检查,结果提示为里宾病,并进行了活检,活检结果支持里宾病的诊断。患者接受了一个疗程的镇痛药治疗,但症状未改善。查阅文献后,对患者实施了右胫骨髓内扩孔术。术后,患者症状改善,在过去4年中一直无疼痛。

结论

里宾病是导致常见症状的不常见病因。它是一种罕见的骨干硬化性发育异常。缺乏感染的临床体征及代谢性骨病的生化证据,同时具备支持里宾病的阳性临床、放射学及组织学特征,这些帮助我们做出了诊断。对受累骨骼进行髓内扩孔术有助于改善症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c85/7885652/fb9c5ff4c3a1/JOCR-10-69-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c85/7885652/dfa96f9e9136/JOCR-10-69-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c85/7885652/fb978512e21f/JOCR-10-69-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c85/7885652/9aaa12ecc106/JOCR-10-69-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c85/7885652/f948e7885c85/JOCR-10-69-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c85/7885652/7a6885532e95/JOCR-10-69-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c85/7885652/fb9c5ff4c3a1/JOCR-10-69-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c85/7885652/dfa96f9e9136/JOCR-10-69-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c85/7885652/fb978512e21f/JOCR-10-69-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c85/7885652/9aaa12ecc106/JOCR-10-69-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c85/7885652/f948e7885c85/JOCR-10-69-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c85/7885652/7a6885532e95/JOCR-10-69-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c85/7885652/fb9c5ff4c3a1/JOCR-10-69-g006.jpg

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Ribbing disease of tibia: a rare entity.胫骨肋状病:一种罕见的疾病。

本文引用的文献

1
Imaging features and differential diagnosis of multiple diaphyseal sclerosis: A case report and review of literature.多发性骨干硬化的影像学特征及鉴别诊断:一例报告并文献复习
Medicine (Baltimore). 2018 Aug;97(33):e11725. doi: 10.1097/MD.0000000000011725.
2
Ribbing disease: a systematic review.肋骨病:一项系统综述。
Acta Radiol. 2018 Apr;59(4):448-453. doi: 10.1177/0284185117719575. Epub 2017 Jul 10.
3
[Intramedullary reaming in Ribbing disease].[肋骨增生症中的髓内扩髓]
BMJ Case Rep. 2021 Oct 28;14(10):e244868. doi: 10.1136/bcr-2021-244868.
Rev Esp Cir Ortop Traumatol. 2013 May-Jun;57(3):231-4. doi: 10.1016/j.recot.2013.02.004. Epub 2013 Apr 11.
4
Ribbing disease: a case report and literature review.肋骨病:一例病例报告及文献综述
Acta Orthop Traumatol Turc. 2011;45(1):58-65. doi: 10.3944/AOTT.2010.2421.
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Ribbing disease.里宾病
Indian J Radiol Imaging. 2010 Feb;20(1):47-9. doi: 10.4103/0971-3026.59754.
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MRI in Ribbing disease-a case report.肋骨病的磁共振成像——病例报告
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[Etiopathogenetic, clinical and radiographic considerations on Ribbing's disease. (Report of 2 cases of familial nature)].[关于里宾病的病因病理、临床及影像学思考。(2例家族性病例报告)]
Arch Putti Chir Organi Mov. 1962;16:58-72.
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