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化疗后距骨骨坏死：一例报告

Talus Osteonecrosis after Chemotherapy: A Case Report.

作者信息

Barros Larissa Macedo, Cortez Pedro Paulo Ribeiro, Souza Emanuella Vaccarezza de, Mendes Eugênio Cesar

机构信息

Serviço de Ortopedia e Traumatologia, Hospital das Clínicas Samuel Libânio (HCSL), UNIVÁS, Pouso Alegre, MG, Brasil.

Serviço de Oncologia Pediátrica, Hospital das Clínicas Samuel Libânio (HCSL), UNIVÁS, Pouso Alegre, MG, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2024 Apr 22;59(Suppl 2):e224-e227. doi: 10.1055/s-0043-1771004. eCollection 2024 Nov.

DOI:10.1055/s-0043-1771004
PMID:39735450
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11679636/
Abstract

This paper described a case of talus osteonecrosis in a 13-year-old female with a diagnosis of T-type acute lymphocytic leukemia, who underwent chemotherapy and treatment with glucocorticoids, attended at the Orthopedics and Traumatology Sector of our institution. After approximately six months of treatment, the patient began to complain of sporadic pain in her left ankle with progressive worsening. Bone scintigraphy and magnetic resonance imaging of the ankles showed the presence of avascular osteonecrosis of the bilateral talar body. We opted for non-surgical treatment with analgesia and anti-inflammatory drugs, in addition to removal of the load associated with the use of immobilization of the extramedullary tutor for four weeks, followed by physical therapy rehabilitation with analgesia and progressive increase in load.

摘要

本文描述了一名13岁女性距骨坏死病例，该患者诊断为T型急性淋巴细胞白血病，在我院骨科和创伤科接受了化疗和糖皮质激素治疗。治疗约六个月后，患者开始抱怨左脚踝偶发疼痛且逐渐加重。踝关节的骨闪烁显像和磁共振成像显示双侧距骨体存在缺血性骨坏死。我们选择了非手术治疗，使用镇痛和抗炎药物，此外还去除了与使用髓外支架固定四周相关的负荷，随后进行镇痛的物理治疗康复，并逐渐增加负荷。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c89c/11679636/241e23b9cdcf/10-1055-s-0043-1771004-i2200153pt-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c89c/11679636/0c7b5bba27e1/10-1055-s-0043-1771004-i2200153en-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c89c/11679636/57735a2af08a/10-1055-s-0043-1771004-i2200153en-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c89c/11679636/dcc30c434000/10-1055-s-0043-1771004-i2200153en-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c89c/11679636/335d5b9d5a15/10-1055-s-0043-1771004-i2200153pt-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c89c/11679636/ace564a311b9/10-1055-s-0043-1771004-i2200153pt-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c89c/11679636/241e23b9cdcf/10-1055-s-0043-1771004-i2200153pt-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c89c/11679636/0c7b5bba27e1/10-1055-s-0043-1771004-i2200153en-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c89c/11679636/57735a2af08a/10-1055-s-0043-1771004-i2200153en-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c89c/11679636/dcc30c434000/10-1055-s-0043-1771004-i2200153en-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c89c/11679636/335d5b9d5a15/10-1055-s-0043-1771004-i2200153pt-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c89c/11679636/ace564a311b9/10-1055-s-0043-1771004-i2200153pt-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c89c/11679636/241e23b9cdcf/10-1055-s-0043-1771004-i2200153pt-3.jpg

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本文引用的文献

1
Effects of zoledronic acid on osteonecrosis and acute lymphoblastic leukemia treatment efficacy in preclinical models.唑来膦酸对临床前模型中骨坏死和急性淋巴细胞白血病治疗效果的影响。
Pediatr Blood Cancer. 2021 Oct;68(10):e29183. doi: 10.1002/pbc.29183. Epub 2021 Jun 14.
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The pathogenesis, diagnosis and clinical manifestations of steroid-induced osteonecrosis.类固醇诱导性骨坏死的发病机制、诊断和临床表现。
J Autoimmun. 2020 Jun;110:102460. doi: 10.1016/j.jaut.2020.102460. Epub 2020 Apr 16.
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Osteonecrosis of the talus of a child with acute lymphoblastic leukemia: A case report.
儿童急性淋巴细胞白血病距骨骨坏死：病例报告。
Foot (Edinb). 2020 Mar;42:101649. doi: 10.1016/j.foot.2019.10.004. Epub 2019 Oct 24.
4
Epidemiology, Cause, and Anatomy of Osteonecrosis of the Foot and Ankle.足踝部骨坏死的流行病学、病因及解剖学
Foot Ankle Clin. 2019 Mar;24(1):1-16. doi: 10.1016/j.fcl.2018.10.001.
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Osteonecrosis in children with acute lymphoblastic leukemia at initial diagnosis and prior to any chemotherapy.儿童急性淋巴细胞白血病初诊时及化疗前的骨坏死。
Leuk Lymphoma. 2019 Jan;60(1):78-84. doi: 10.1080/10428194.2018.1466292. Epub 2018 May 2.
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Osteonecrosis in children with acute lymphoblastic leukemia.急性淋巴细胞白血病患儿的骨坏死
Haematologica. 2016 Nov;101(11):1295-1305. doi: 10.3324/haematol.2016.147595. Epub 2016 Oct 14.
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Assessment of corticosteroid-induced osteonecrosis in children undergoing chemotherapy for acute lymphoblastic leukemia: a report from the Japanese Childhood Cancer and Leukemia Study Group.急性淋巴细胞白血病化疗儿童中皮质类固醇诱导性骨坏死的评估：来自日本儿童癌症与白血病研究组的报告
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Multifocal osteonecrosis following chemotherapy and short-term corticosteroid therapy in a patient with small-cell bronchogenic carcinoma.一名小细胞支气管肺癌患者在化疗及短期皮质类固醇治疗后发生多灶性骨坏死。
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