Xie Lun-Li, Yuan Xiao, Zhu Hong-Xia, Pu Dan
Department of Joint and Hand Orthopedics, Hunan University of Medicine General Hospital, Huaihua 418000, Hunan Province, China.
Department of Joint and Hand Surgery, Hunan University of Medicine General Hospital, Huaihua 418000, Hunan Province, China.
World J Clin Cases. 2023 Sep 16;11(26):6170-6175. doi: 10.12998/wjcc.v11.i26.6170.
Fibrous dysplasia associated with aneurysmal bone cyst (ABC)-like changes in the right proximal femur has a low incidence. It is considered more difficult to make early diagnosis than for single fibrous dysplasia.
A 14-year-old woman was admitted because of persistent pain in the right hip and abnormal gait over the previous 2 mo. She had no history of present or past illness. Preoperative photography, enhanced computed tomography, and magnetic resonance imaging showed ground-glass appearance with cortical scalloping and expansion of the right proximal femur and femoral neck. Pathological examination by preoperative puncture biopsy revealed fibrous dysplasia of the right proximal femur. The patient was diagnosed with fibrous dysplasia based on medical history, physical examination, and results of laboratory, imaging and pathological examinations. According to final pathological examination, the patient was diagnosed with fibrous dysplasia of the right proximal femur associated with ABC. Curettage and allograft along with fixation of compression screws was performed for fibrous dysplasia associated with ABC-like changes. No obvious allograft absorption, loosening of fixation, or secondary fracture were observed during 6-months' follow-up with re-examination by plain radiography and computed tomography. Fibrous dysplasia associated with ABC-like changes in the right proximal femur has a low incidence and early diagnosis is considered more difficult than for single fibrous dysplasia.
We report a cases of fibrous dysplasia associated with ABC-like changes in the right proximal femur treated with curettage and allograft along with hip compression screws.
右股骨近端纤维发育不良合并动脉瘤样骨囊肿（ABC）样改变的发病率较低。与单纯纤维发育不良相比，其早期诊断被认为更困难。
一名14岁女性因右髋部持续疼痛及异常步态2个月入院。她无现病史及既往病史。术前摄影、增强计算机断层扫描及磁共振成像显示右股骨近端及股骨颈呈磨玻璃样外观，伴有皮质扇贝样改变及骨质膨胀。术前穿刺活检病理检查显示右股骨近端纤维发育不良。根据病史、体格检查及实验室、影像学和病理检查结果，该患者被诊断为纤维发育不良。最终病理检查显示，该患者被诊断为右股骨近端纤维发育不良合并ABC。对合并ABC样改变的纤维发育不良行刮除、同种异体骨移植及加压螺钉固定术。在术后6个月的随访中，通过X线平片和计算机断层扫描复查，未观察到明显的同种异体骨吸收、固定松动或二次骨折。右股骨近端纤维发育不良合并ABC样改变的发病率较低，且早期诊断被认为比单纯纤维发育不良更困难。
我们报告了1例右股骨近端纤维发育不良合并ABC样改变的病例，采用刮除、同种异体骨移植及髋部加压螺钉治疗。
