Macho Fernández J M, Manero Ruiz F J, Soriano Godes J J, Otero Sierra C, Ros Mendoza L H
Servicio de Radiodiagnóstico, Hospital Miguel Servet, Zaragoza.
Rev Clin Esp. 1996 May;196(5):306-9.
Algodystrophy is a common entity which may present in many clinical contexts. Its early diagnosis and therapy are of great prognostic interest. Apart from the typical complete forms there are some other atypical forms, such as partial knee algodystrophy, of difficult diagnosis. Its inclusion in the differential diagnosis of gonalgia occurring in patients attended under many medical specialties is therefore necessary. Two atypical cases of knee algodystrophy in its partial form are reported. One of these cases relapsed at the heterolateral knee after 18 months of the initial presentation; this second episode was also a partial form, a fact which we have not seen reported. The reported cases are here discussed and the scarce literature is reviewed, commenting on the difficulty of the early diagnosis compared with other entities which may mimic the clinical picture, radiological and scanning features of algodystrophy, such as aseptic osteonecrosis or stress fracture. The diagnostic algorithm is discussed, pointing to the usefulness of magnetic resonance (MR) in difficult cases to rule out other entities which would entail different therapeutic modalities.
痛性营养不良是一种常见病症，可出现在多种临床情况中。其早期诊断和治疗对预后具有重要意义。除了典型的完整形式外，还有一些其他非典型形式，如部分膝关节痛性营养不良，诊断困难。因此，有必要将其纳入多个医学专科就诊患者膝痛的鉴别诊断中。本文报告了两例部分形式的非典型膝关节痛性营养不良病例。其中一例在初次发病18个月后对侧膝关节复发；第二次发作也是部分形式，这一情况我们未见有报道。本文对所报告的病例进行了讨论，并回顾了相关的稀少文献，阐述了与其他可能模拟痛性营养不良临床症状、放射学和扫描特征的疾病（如无菌性骨坏死或应力性骨折）相比，早期诊断的困难之处。文中讨论了诊断算法，指出在疑难病例中磁共振成像（MR）对于排除其他需要不同治疗方式的疾病的有用性。
