Lequesne M, Kerboull M, Bensasson M, Perez C, Dreiser M, Forest A
Rev Rhum Mal Osteoartic. 1979 Feb;46(2):111-21.
Partial decalcifying algodystrophy (PDA) appears in two forms: one, a radial form, affects, following a certain metameric topography, one or two radiuses of the hand or of the foot (two cases reported); the other, a zonal form, is more peculiar: only part of a condyle or of the femoral head, are demineralized for two to three months. The authors report 7 cases of this misleading zonal form, 2 of them after histological verification. The image leads to various diagnostic errors: osteitis or infectious osteo-arthritis, acute inflammation close to the bone, and especially malignant processes. However, zonal PDA has its own characteristics: demineralization, that becomes clear only during the second month, and quickly extends over a rather long sub chondral bone surface. Tomography is very useful: it demonstrates better the severe sub chondral osteoporosis and the retention of the bone sole, which becomes detached from the bone. Scintigraphy shows the massive localized or panregional hyperfixation and sometimes other infraradiological sites (hips, knee or ankle). Zonal osteoporosis remains partial and misleading for only 2 or 3 months, after which it becomes a classical panregional form. The rate of development is that of DA. Painful impotence quickly increases, with cure in 6 months.
部分脱钙性骨营养不良（PDA）有两种表现形式：一种是放射状形式，按照一定的节段性分布模式，影响手部或足部的一个或两个放射状区域（报道过两例）；另一种是带状形式，更为特殊：只有部分髁或股骨头在两到三个月内发生脱矿质。作者报告了7例这种具有误导性的带状形式病例，其中2例经组织学证实。这种影像会导致各种诊断错误：骨炎或感染性骨关节炎、骨附近的急性炎症，尤其是恶性病变。然而，带状PDA有其自身特点：脱矿质仅在第二个月才变得明显，并迅速扩展到相当长的软骨下骨表面。断层扫描非常有用：它能更好地显示严重的软骨下骨质疏松以及从骨上分离的骨底残留。闪烁扫描显示大量局部或全区域的放射性浓聚，有时还显示其他放射线下的部位（髋部、膝部或踝部）。带状骨质疏松仅在2或3个月内保持局部且具有误导性，之后会转变为典型的全区域形式。发展速度与骨营养不良相同。疼痛性性功能障碍迅速加重，6个月内治愈。
