Wignall T A, Carrington B M, Logue J P
Department of Diagnostic Radiology, Christie Hospital NHS Trust, Withington, Manchester, UK.
Clin Radiol. 1998 Feb;53(2):126-30. doi: 10.1016/s0009-9260(98)80059-7.
We report the clinical and computed tomography (CT) features of seven patients with osteomyelitis of the symphysis pubis following radiotherapy for bladder (n=4) or cervical (n=3) carcinoma. The patients presented with fistulae (n=5), pain (n=1) or small bowel obstruction (n=1) between 6 and 19 years after radiotherapy. The diagnosis was confirmed by surgery with histology or bacteriology of the symphysis pubis and/or associated abscess in all patients. In addition to bone destruction, other features identified on CT included abscesses, bowel loops adherent to the symphysis pubis and/or communicating with an abscess cavity, a soft tissue mass enveloping the residual bone, and fistulae. The combination of clinical and radiological features suggests osteomyelitis and, for patients who have had pelvic radiotherapy, this treatable condition should be included in the differential diagnosis of solitary symphysis pubis destruction.
我们报告了7例耻骨联合骨髓炎患者的临床及计算机断层扫描（CT）特征，这些患者均因膀胱癌（n = 4）或宫颈癌（n = 3）接受过放疗。患者在放疗后6至19年间出现瘘管（n = 5）、疼痛（n = 1）或小肠梗阻（n = 1）。所有患者均通过耻骨联合及/或相关脓肿的手术组织学或细菌学检查确诊。除骨质破坏外，CT上发现的其他特征还包括脓肿、与耻骨联合粘连和/或与脓肿腔相通的肠袢、包绕残留骨质的软组织肿块以及瘘管。临床和影像学特征相结合提示为骨髓炎，对于接受过盆腔放疗的患者，这种可治疗的疾病应纳入孤立性耻骨联合破坏的鉴别诊断。
