COVID-19 后膝关节骨坏死。
Knee osteonecrosis after COVID-19.
机构信息
SERMAS, EAP Adelfas, M.P. Avenida Ciudad de Barcelona, Madrid, Spain.
出版信息
Fam Pract. 2021 Aug 27;38(Suppl 1):i45-i47. doi: 10.1093/fampra/cmab063.
BACKGROUND
COVID-19 is an emergent infection, the long-term complications of which are still under study. While hypercoagulability is a common feature in severe cases, the incidence of ischemic complications such as osteonecrosis remains unknown. Previous studies on SARS-CoV1 found an increase in osteonecrosis 3-36 months after infection, and it is still unclear if this was related to the use of corticosteroids or to the virus itself.
METHODS
We introduce a 78-year-old woman who complained of right knee pain and swelling a month after COVID-19 infection onset. Her knee radiography showed no significant changes compared to previous ones. MRI, on the other hand, found osteonecrosis in the internal femoral condyle. No coagulation abnormalities were found in blood tests.
RESULTS
While knee replacement should be her main treatment, it will be long delayed due to the pandemic. In the meantime, we increased her tapentadol and salicylic acid doses and gave her home exercises to improve functionality.
CONCLUSION
In the follow-up after COVID-19, any muscular or joint pain with unusual characteristics should be carefully examined.
背景
COVID-19 是一种新出现的感染，其长期并发症仍在研究中。虽然在重症病例中普遍存在高凝状态，但诸如骨坏死等缺血性并发症的发生率尚不清楚。之前对 SARS-CoV1 的研究发现，感染后 3-36 个月骨坏死的发生率增加，目前尚不清楚这是否与使用皮质类固醇或与病毒本身有关。
方法
我们介绍了一位 78 岁的女性患者，她在 COVID-19 感染发病后一个月出现右膝疼痛和肿胀。她的膝关节 X 线片与之前的相比没有明显变化。然而，MRI 发现股骨内髁骨坏死。血液检查未发现凝血异常。
结果
虽然膝关节置换术应该是她的主要治疗方法，但由于疫情，这将被长期推迟。在此期间，我们增加了她的曲马多和水杨酸的剂量，并让她在家中进行锻炼以改善功能。
结论
在 COVID-19 随访中，任何具有异常特征的肌肉或关节疼痛都应仔细检查。
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