Stern P J, Côté P, Dust W
Canadian Memorial Chiropractic College, Toronto, Ontario.
J Manipulative Physiol Ther. 1994 Sep;17(7):485-8.
To present a rare case of pelvic insufficiency fracture mistaken for metastatic bone disease.
A 58-yr-old female received 3 wk of chiropractic treatment for mechanical low back pain. The treatment offered no relief. Two months later, a bone scan revealed increased uptake in the pelvis, suggesting metastatic bone disease. A CT scan demonstrated several pubic fractures. Subsequent biopsy failed to show evidence of malignancy. A diagnosis of insufficiency fractures secondary to osteoporosis was made.
She was referred to a rehabilitation clinic for physiotherapy and medication. She consulted a rheumatologist and was prescribed calcitonin. Ten months later, she was improved and the fractures had united.
The absence of trauma frequently delays the diagnosis of parasymphyseal insufficiency fracture. The ambiguous X-ray features often lead to a diagnosis of metastatic bone disease. Early detection is important as significant morbidity may result from delaying the treatment.
呈现一例罕见的被误诊为骨转移疾病的骨盆不全骨折病例。
一名58岁女性因机械性下背痛接受了3周的脊椎按摩治疗。治疗后疼痛未缓解。两个月后，骨扫描显示骨盆摄取增加，提示骨转移疾病。CT扫描显示数处耻骨骨折。随后的活检未发现恶性肿瘤证据。诊断为骨质疏松继发的不全骨折。
她被转至康复诊所接受物理治疗和药物治疗。她咨询了风湿病专家并被开了降钙素。十个月后，她病情好转，骨折已愈合。
无外伤史常常会延误耻骨联合不全骨折的诊断。X线表现不明确常导致骨转移疾病的诊断。早期检测很重要，因为延误治疗可能导致严重的发病率。
