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一名 11 岁女孩双侧髌骨骨软骨缺损。

Bilateral osteochondral defects of the patellae in an 11-year-old girl.

机构信息

Trauma and Orthopaedics, Royal Free London NHS Trust, London, UK

University College London, London, UK.

出版信息

BMJ Case Rep. 2021 Apr 23;14(4):e240790. doi: 10.1136/bcr-2020-240790.

Abstract

Osteochondral defect or osteochondritis dissecans (OCD) of the knee usually affects young, active populations. It is a challenging diagnosis as patients typically present with poorly localised activity-related pain, which is non-specific and covers many differentials. We present an active 11-year-old girl with bilateral osteochondral defects of the patellae: a rare clinical disorder which was affecting her sporting activities. She had a 12-month history of bilateral anterior knee pain before the diagnosis was achieved with appropriate imaging. Her pain significantly improved with activity modification and physiotherapy. Follow-up will require outpatient clinic assessment and imaging to determine if non-operative management continues to be successful or surgery may be required. This case report emphasises the importance of appropriate high index of suspicion when managing patients with non-specific knee pain. It also demonstrates the importance of judicious use of imaging to avoid a missed or delayed diagnosis.

摘要

膝关节的骨软骨缺损或剥脱性骨软骨炎(OCD)通常影响年轻、活跃的人群。这是一个具有挑战性的诊断,因为患者通常表现为定位不佳的与活动相关的疼痛,这种疼痛是非特异性的,涵盖了许多不同的病因。我们报告了一例 11 岁的活跃女孩双侧髌骨骨软骨缺损:这是一种罕见的临床疾病,影响了她的运动活动。在做出适当的影像学诊断之前,她有 12 个月的双侧膝关节前疼痛病史。通过活动调整和物理治疗,她的疼痛显著改善。随访需要门诊评估和影像学检查,以确定非手术治疗是否继续有效,或者是否需要手术。本病例报告强调了在管理非特异性膝关节疼痛患者时,适当提高怀疑指数的重要性。它还表明了明智使用影像学检查以避免漏诊或延迟诊断的重要性。

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Juvenile osteochondritis dissecans (JOCD) of the knee: current concepts review.膝关节青少年剥脱性骨软骨炎:当前概念综述
EFORT Open Rev. 2019 May 17;4(5):201-212. doi: 10.1302/2058-5241.4.180079. eCollection 2019 May.
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Osteochondral Injuries of the Knee in Pediatric Patients.小儿膝关节骨软骨损伤
J Knee Surg. 2018 May;31(5):382-391. doi: 10.1055/s-0038-1625956. Epub 2018 Jan 30.
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Osteochondritis dissecans of the knee.膝关节剥脱性骨软骨炎
Orthop Traumatol Surg Res. 2018 Feb;104(1S):S97-S105. doi: 10.1016/j.otsr.2017.02.016. Epub 2017 Nov 29.

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