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糖尿病患者骨化性肌炎的罕见表现。

A Rare Presentation of Myositis Ossificans in a Diabetic Individual.

作者信息

Jogiya Prabodhinee Dhiren, Hind Jamie, Sidhu Gur Aziz Singh, Suryawanshi Suraj, Amara Veda Vani, Ashwood Neil

机构信息

Department of Life Sciences, University of Leicester, Leicester, England.

Department Trauma and Orthopaedics, Queen's Hospital, Burton, England.

出版信息

J Orthop Case Rep. 2022 Oct;12(10):50-53. doi: 10.13107/jocr.2022.v12.i10.3362.

Abstract

INTRODUCTION

Myositis ossificans (MO) is a disease with self-limiting, benign ossifying lesions. MO traumatica is most common cause and occurs after blunt trauma to muscle tissue and the most common site of occurrence is the anterior thigh often developing after an intramuscular hematoma. The pathophysiology of MO is not well understood. The association of myositis and diabetes is quite rare.

CASE REPORT

A 57-year-old male presented with a discharging ulcer on the right lateral lower leg. A radiograph was carried out to ascertain the degree of bone involvement. However, the X-ray showed calcifications. Ultrasound, magnetic resonance imaging (MRI) and X-ray imaging were used to exclude malignant disorders such as osteomyelitis or osteosarcoma. The diagnosis of myositis ossificans was confirmed with MRI. As the patient had a background of diabetes, this could have led to MO as a result of the macrovascular complication of a discharging ulcer; hence, diabetes could be considered a risk factor for the disease.

CONCLUSION

The reader may appreciate that diabetic patients may present with MO and that repeated discharging ulcers may imitate the effects of physical trauma on calcifications. The specific take home message is that regardless of the apparent rarity of a disease and subversion to typical clinical presentation, it should still be considered. Furthermore, the exclusion of severe and malignant diseases which benign diseases may mimic is of utmost importance to correctly manage patients.

摘要

引言

骨化性肌炎(MO)是一种具有自限性的良性骨化性病变疾病。创伤性骨化性肌炎是最常见的病因,发生于肌肉组织受到钝性创伤后,最常见的发病部位是大腿前部,常继发于肌内血肿后。骨化性肌炎的病理生理学尚不清楚。肌炎与糖尿病的关联相当罕见。

病例报告

一名57岁男性患者,右下肢外侧出现一个有分泌物的溃疡。进行了X线检查以确定骨受累程度。然而,X线显示有钙化。超声、磁共振成像(MRI)和X线成像用于排除骨髓炎或骨肉瘤等恶性疾病。MRI确诊为骨化性肌炎。由于该患者有糖尿病病史,这可能因有分泌物的溃疡的大血管并发症导致骨化性肌炎;因此,糖尿病可被视为该疾病的一个危险因素。

结论

读者可能认识到糖尿病患者可能出现骨化性肌炎,反复出现的有分泌物的溃疡可能模拟物理创伤对钙化的影响。具体的关键信息是,无论一种疾病看似多么罕见以及与典型临床表现不符,仍应予以考虑。此外,排除良性疾病可能模仿的严重和恶性疾病对于正确治疗患者至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0f6/9983389/058a6454a6ab/JOCR-12-50-g001.jpg

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