Yoshikawa Y, Morii T, Mitsugi N, Hiruma T, Koshino T, Kushida K, Kurosaka T
Department of Orthopaedic Surgery, Yokohama City University, School of Medicine.
Ryumachi. 1993 Oct;33(5):424-31.
The cases with pustulosis palmaris et plantaris associated with lesions in sterno-cost clavicular region, spine and ilio sacral joint have been in the previous literatures. We encountered four rare cases of this pustulosis in association with femoral lesion. We mainly reported their radiological and pathologic findings. Three cases had lesions in the diaphysis of the femur, while one case had lesion in the lesser trochanter. The average age was 55.5 years (range 53-60) All patients complained of thigh pain. Three cases suffered sterno cost clavicular pain also. Laboratory data showed the elevation of white blood cell number, ESR and tested positive for C-reactive protein. The radiological findings showed osteolytic lesions of the femoral cortex at the onset of the disease, followed by thickening and sclerosis in the cortex. A biopsy was performed in three cases and the pathological results showed no malignancy. The specimens showed only chronic inflammation. Pathological results and radiological abnormalities suggested that femoral lesion of pustulosis palmaris et plantaris originated from the periostenum or the cortex of bone.
掌跖脓疱病合并胸锁关节、脊柱及骶髂关节病变的病例在以往文献中已有记载。我们遇到了4例这种掌跖脓疱病合并股骨病变的罕见病例。我们主要报告了它们的影像学和病理学表现。3例病变位于股骨干，1例病变位于小转子。平均年龄为55.5岁（范围53 - 60岁）。所有患者均主诉大腿疼痛。3例还伴有胸锁关节疼痛。实验室数据显示白细胞计数、血沉升高，C反应蛋白检测呈阳性。影像学表现为疾病初期股骨干皮质出现溶骨性病变，随后皮质增厚、硬化。3例进行了活检，病理结果显示无恶性病变。标本仅显示慢性炎症。病理结果和影像学异常提示掌跖脓疱病的股骨病变起源于骨膜或骨皮质。
