Wang Jie, Zhang Yao, Zhao Changsong, Zhang Qiang
Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China.
Infect Drug Resist. 2022 Oct 10;15:5857-5865. doi: 10.2147/IDR.S383584. eCollection 2022.
The causes of femoral head necrosis mainly include trauma, corticosteroid, and alcohol, among which is highly unusual.
This paper reported three rare cases of femoral head necrosis due to , summarizing and analyzing the epidemiological history, clinical manifestations, laboratory examinations, imaging findings, individualized therapy, and biopsy results of patients with this disease. A literature review related to brucellosis and femoral head necrosis was conducted.
All three patients had an epidemic history of brucellosis. They suffered from hip pain and limitation of movement for months, and femoral head necrosis was confirmed by magnetic resonance imaging (MRI). Pathological Giemsa staining or real-time polymerase chain reaction (real-time PCR) confirmed () as the cause of osteonecrosis. Each patient received individualized therapy according to the degree of osteonecrosis, which was based on anti-brucellosis medications and hip puncture and irrigation decompression. They were followed up for more than two years and rehabilitated well.
infection should always be considered the cause of femoral head necrosis for patients with hip pain, especially for those with an epidemic history; early diagnosis and individual stepwise therapy can prevent the progression of osteonecrosis.
股骨头坏死的病因主要包括创伤、皮质类固醇和酒精，其中[病因未明确提及]极为罕见。
本文报告了3例因[病因未明确提及]导致的罕见股骨头坏死病例，总结并分析了该病患者的流行病学史、临床表现、实验室检查、影像学表现、个体化治疗及活检结果。同时进行了与布鲁氏菌病和股骨头坏死相关的文献综述。
所有3例患者均有布鲁氏菌病流行病史。他们数月来一直遭受髋关节疼痛和活动受限，磁共振成像（MRI）确诊为股骨头坏死。病理吉姆萨染色或实时聚合酶链反应（实时PCR）证实[病因未明确提及]为骨坏死原因。每位患者根据骨坏死程度接受个体化治疗，治疗基于抗布鲁氏菌病药物及髋关节穿刺冲洗减压。对他们进行了两年多的随访，康复情况良好。
对于髋关节疼痛患者，尤其是有流行病史者，应始终考虑[病因未明确提及]感染为股骨头坏死的病因；早期诊断和个体化的逐步治疗可预防骨坏死进展。
