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新型冠状病毒肺炎(SARS-CoV-2)所致低创伤性原发性髋关节后脱位伴急性纵向横贯性脊髓炎——病例报告

Low trauma posterior native hip dislocation with acute longitudinal transverse myelitis due to SARS-CoV-2 - A case-report.

作者信息

Pandya Chiraag, Sangoi Dhrumin, Badhe Sachin

机构信息

Department of Trauma and Orthopaedic, Kings Mill Hospital, Sherwood Forest Hospitals NHS Foundation Trust, Mansfield Road, Sutton-in-Ashton NG17 4JL, United Kingdom.

出版信息

Trauma Case Rep. 2021 Aug;34:100501. doi: 10.1016/j.tcr.2021.100501. Epub 2021 Jun 16.

Abstract

BACKGROUND

Native hip dislocations are most commonly seen after high energy trauma. While there are documented cases of hip dislocation with associated stroke, we present a case of posterior hip dislocation in the context of acute longitudinal transverse myelitis due to a rare presentation of SARS-CoV-2.

CASE REPORT

A 60-year-old male presented with bilateral lower limb weakness with a shortened internally rotated left leg. Plain radiographs revealed a posteriorly dislocated native left hip and MRI of the spine showed acute longitudinal transverse myelitis of the cervical and thoracic regions. His nasopharyngeal swab was positive for SARS-CoV-2. His hip was reduced, and he was treated with intravenous steroids. His neurological symptoms improved with follow-up MRI showing resolution of the transverse myelitis.

CONCLUSION

This case illustrates a classic orthopaedic emergency in the context of a rare presentation of SARS-CoV-2, and the vigilance that orthopaedic doctors must have when examining patients with lower limb neurological deficit.

摘要

背景

原发性髋关节脱位最常见于高能量创伤后。虽然有髋关节脱位合并中风的病例记录,但我们报告一例因罕见的新型冠状病毒感染表现为急性纵向横贯性脊髓炎背景下的后髋关节脱位病例。

病例报告

一名60岁男性出现双侧下肢无力,左腿内旋缩短。X线平片显示左侧原发性髋关节后脱位,脊柱MRI显示颈段和胸段急性纵向横贯性脊髓炎。他的鼻咽拭子新型冠状病毒检测呈阳性。他的髋关节复位,接受了静脉注射类固醇治疗。随访MRI显示横贯性脊髓炎消退,其神经症状有所改善。

结论

本病例说明了在罕见的新型冠状病毒感染表现背景下的典型骨科急症,以及骨科医生在检查下肢神经功能缺损患者时必须保持的警惕性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9c5/8255245/c985b8bdf068/gr1.jpg

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