From the Departments of Radiology (M.J.M., J.S.S.), Neurosurgery (J.A.G.), and Endocrinology (J.A.S.), Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226.
Radiology. 2022 Feb;302(2):484-488. doi: 10.1148/radiol.203739.
History A 37-year-old man from the United States presented with a 1-year history of neck pain and stiffness that had been unsuccessfully treated with manipulative therapy by a chiropractor at another institution. Past medical history was remarkable only for marijuana and air duster abuse. He denied use of any prescription medications. Physical examination was notable for markedly reduced range of motion of the cervical spine. Laboratory work-up revealed an elevated alkaline phosphatase level (302 U/L [5.0 μkat/L]; normal range, 40-100 U/L [0.7-1.67 μkat/L]), but all other laboratory findings, including complete blood count, renal function, liver function, vitamin A level, serum protein electrophoresis, and hepatitis C antibodies were within normal limits. Cervical spine radiography was performed, followed by MRI. Subsequently, a full skeletal survey was ordered. Included are representative radiographs of the pelvis, left forearm, and distal right leg with ankle.
病史 一名 37 岁的美国男性，因颈部疼痛和僵硬 1 年就诊，此前在另一家医疗机构接受过脊椎按摩师的手法治疗，但未成功。既往病史仅为滥用大麻和空气清新剂。他否认使用任何处方药物。体格检查显示颈椎活动范围明显受限。实验室检查发现碱性磷酸酶水平升高（302U/L[5.0μkat/L]；正常值范围，40-100U/L[0.7-1.67μkat/L]），但其他所有实验室检查结果，包括全血细胞计数、肾功能、肝功能、维生素 A 水平、血清蛋白电泳和丙型肝炎抗体均在正常范围内。进行了颈椎 X 线摄影，随后进行了 MRI。随后，进行了全身骨骼检查。包括骨盆、左前臂和右小腿远端伴踝关节的代表性 X 线片。
