General Paediatrics, The Royal Children's Hospital, Parkville, Victoria, Australia
Rheumatology, Monash Children's Hospital, Clayton, Victoria, Australia.
BMJ Case Rep. 2022 Aug 29;15(8):e245179. doi: 10.1136/bcr-2021-245179.
We describe an infant presenting with intermittent discolouration and swelling of her fingers and toes occurring with changes in ambient temperature. Extensive investigations revealed raised inflammatory markers as well as sclerotic lesions within the phalanges and diffuse marrow oedema. Infectious and inflammatory causes were considered and excluded based on the clinical presentation and investigation findings. The persistence of symptoms prompted further investigation with MRI. Correlation of the MRI findings with previous case reports resulted in a diagnosis of microgeodic disease-an uncommon, self-limiting condition thought to be due to cold-induced vasospasm leading to avascular necrosis of the bone.
我们描述了一名婴儿，其手指和脚趾会随着环境温度的变化间歇性变色和肿胀。广泛的检查显示炎症标志物升高，以及指骨内的硬化性病变和弥漫性骨髓水肿。根据临床表现和检查结果，考虑了感染和炎症性原因，并排除了这些原因。症状持续存在促使进一步进行 MRI 检查。MRI 检查结果与之前的病例报告相关联，导致诊断为微结石病——一种罕见的、自限性疾病，据信是由于冷诱导的血管痉挛导致骨的缺血性坏死。
