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髋关节结核性脓毒性关节炎伴巨大脓肿形成,酷似软组织肿瘤:一例报告。

Tuberculous septic arthritis of the hip with large abscess formation mimicking soft tissue tumors: A case report.

作者信息

Prasetyo Marcel, Adistana Indah Maria, Setiawan Stefanus Imanuel

机构信息

Department of Radiology, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia.

出版信息

Heliyon. 2021 Apr 17;7(4):e06815. doi: 10.1016/j.heliyon.2021.e06815. eCollection 2021 Apr.

Abstract

BACKGROUND

Tuberculous septic arthritis is an infection that occurs inside the joint or synovial fluid and joint tissues caused by . It may show wide variability of clinical symptoms and imaging appearance, ranging from asymptomatic with a normal radiographic examination to severe joint pain along with joint destruction, osteomyelitis, and abscess formation. This article presents radiographic and MR imaging appearance from a case of tuberculous septic arthritis with large abscess formation mimicking soft tissue tumor.

CASE PRESENTATION

We reported a 32-year-old female with a slowly enlarging lump on her right proximal thigh within the last 4 months along with slowly progressing joint pain. Both radiographic and MR images showed destruction of the femoral head and acetabular roof, with a formation of large rim-enhanced abscess that extending superficially and distally until mid-thigh. The patient underwent open drainage surgery and excisional biopsy. Histopathological examination showed chronic granulomatous inflammation caused by tuberculous infection.

CONCLUSION

MR imaging combined with radiographic and clinical information played a very important role in the diagnosis of tuberculous septic arthritis with abscess, and to differentiate it from soft tissue neoplasms.

摘要

背景

结核性化脓性关节炎是一种由……引起的发生于关节内或滑液及关节组织的感染。其临床症状和影像学表现可能具有很大差异,从影像学检查正常的无症状状态到伴有关节破坏、骨髓炎和脓肿形成的严重关节疼痛。本文介绍了一例表现为巨大脓肿形成、酷似软组织肿瘤的结核性化脓性关节炎的影像学及磁共振成像表现。

病例介绍

我们报告了一名32岁女性,在过去4个月里右大腿近端有一个缓慢增大的肿块,并伴有逐渐加重的关节疼痛。影像学和磁共振图像均显示股骨头和髋臼顶破坏,形成一个大的边缘强化脓肿,该脓肿向浅表和远端延伸直至大腿中部。患者接受了切开引流手术及切除活检。组织病理学检查显示为结核感染引起的慢性肉芽肿性炎症。

结论

磁共振成像结合影像学及临床信息在诊断伴有脓肿的结核性化脓性关节炎以及将其与软组织肿瘤鉴别方面发挥了非常重要的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac14/8082261/c99cdd5d08f9/gr1.jpg

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