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病入骨髓。并非所有骨肿瘤都是癌症:长骨骨髓炎病例。

Bad to the bone. Not all bone tumors are cancer: Case of long bone osteomyelitis.

作者信息

Yau Tat W, Franz Bennet D, Osman Hanadi A, Rivera Jessica C, Azhar Ashaur

机构信息

Louisiana State University Health Sciences Center, Department of Medicine, Section of Infectious Diseases, New Orleans, LA, United States.

Louisiana State University, School of Medicine, New Orleans, LA, United States.

出版信息

IDCases. 2023 Sep 28;34:e01897. doi: 10.1016/j.idcr.2023.e01897. eCollection 2023.

DOI:10.1016/j.idcr.2023.e01897
PMID:37790215
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10542419/
Abstract

Long bone osteomyelitis could mimic bony tumor in clinical presentation and imaging studies. We present a case of a 47-year man who presented with leg pain, weight loss and night sweats that initially was thought to be related to osteosarcoma, later suffered a pathologic fracture from osteomyelitis. This case highlights the importance of source control of infection and careful clinical evaluation including radiographic and pathologic findings that can help physicians to differentiate between competing diagnoses.

摘要

长骨骨髓炎在临床表现和影像学检查中可能会与骨肿瘤相似。我们报告一例47岁男性病例,该患者表现为腿痛、体重减轻和盗汗,最初被认为与骨肉瘤有关,后来因骨髓炎发生了病理性骨折。该病例强调了感染源控制以及包括影像学和病理结果在内的仔细临床评估的重要性,这有助于医生区分相互竞争的诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c5/10542419/248aa8036c8a/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c5/10542419/09dc5cae5c5d/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c5/10542419/e1e026ae6937/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c5/10542419/bad062f60ae3/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c5/10542419/022696b913c9/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c5/10542419/248aa8036c8a/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c5/10542419/09dc5cae5c5d/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c5/10542419/e1e026ae6937/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c5/10542419/bad062f60ae3/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c5/10542419/022696b913c9/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c5/10542419/248aa8036c8a/gr5.jpg

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本文引用的文献

1
Staphylococcus aureus Osteomyelitis: Bone, Bugs, and Surgery.金黄色葡萄球菌骨髓炎:骨、细菌和手术。
Infect Immun. 2020 Jun 22;88(7). doi: 10.1128/IAI.00932-19.
2
What are the Optimal Cutoff Values for ESR and CRP to Diagnose Osteomyelitis in Patients with Diabetes-related Foot Infections?ESR 和 CRP 诊断糖尿病相关足部感染患者骨髓炎的最佳截断值是多少?
Clin Orthop Relat Res. 2019 Jul;477(7):1594-1602. doi: 10.1097/CORR.0000000000000718.
3
Use of erythrocyte sedimentation rate and C-reactive protein to predict osteomyelitis recurrence.
利用红细胞沉降率和C反应蛋白预测骨髓炎复发
J Orthop Surg (Hong Kong). 2016 Apr;24(1):77-83. doi: 10.1177/230949901602400118.
4
Distinguishing Osteomyelitis From Ewing Sarcoma on Radiography and MRI.通过X线摄影和磁共振成像鉴别骨髓炎与尤因肉瘤
AJR Am J Roentgenol. 2015 Sep;205(3):640-50; quiz 651. doi: 10.2214/AJR.15.14341.
5
Osteomyelitis of the femur mimicking bone tumors: a review of 10 cases.股骨骨髓炎酷似骨肿瘤:10 例病例回顾。
World J Surg Oncol. 2013 Oct 22;11:283. doi: 10.1186/1477-7819-11-283.
6
Acute haematogenous community-acquired methicillin-resistant Staphylococcus aureus osteomyelitis in an adult: case report and review of literature.成人急性血源性社区获得性耐甲氧西林金黄色葡萄球菌骨髓炎:病例报告及文献复习。
BMC Infect Dis. 2012 Oct 25;12:270. doi: 10.1186/1471-2334-12-270.
7
Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children.美国传染病学会发布的耐甲氧西林金黄色葡萄球菌感染成人和儿童治疗临床实践指南。
Clin Infect Dis. 2011 Feb 1;52(3):e18-55. doi: 10.1093/cid/ciq146. Epub 2011 Jan 4.
8
A history of osteomyelitis from the Journal of Bone and Joint Surgery: 1948 TO 2006.《骨与关节外科杂志》中关于骨髓炎的病史:1948年至2006年
J Bone Joint Surg Br. 2007 May;89(5):667-70. doi: 10.1302/0301-620X.89B5.19170.
9
The 'penumbra sign' on T1-weighted MR imaging in subacute osteomyelitis: frequency, cause and significance.亚急性骨髓炎T1加权磁共振成像上的“半影征”:发生率、成因及意义
Clin Radiol. 1998 Aug;53(8):587-92. doi: 10.1016/s0009-9260(98)80150-5.