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儿童胸锁关节骨肥厚:八例报告

Sternocostoclavicular hyperostosis in children: a report of eight cases.

作者信息

Azouz E M, Jurik A G, Bernard C

机构信息

Department of Medical Imaging, Montréal Children's Hospital, Québec, Canada.

出版信息

AJR Am J Roentgenol. 1998 Aug;171(2):461-6. doi: 10.2214/ajr.171.2.9694476.

Abstract

OBJECTIVE

The aim of this paper is to clarify the clinical and radiologic features of sternocostoclavicular hyperostosis by reviewing eight previously unpublished cases in children, identifying its similarities to chronic recurrent multifocal osteomyelitis and the differences between the pediatric and adult population affected with sternocostoclavicular hyperostosis. Appropriate imaging workup will obviate unnecessary diagnostic and therapeutic procedures.

MATERIALS AND METHODS

We investigated the clinical and imaging features of sternocostoclavicular hyperostosis in eight children (seven girls and one boy) and compared those features with the characteristic features of chronic recurrent multifocal osteomyelitis and sclerosing Garré's osteomyelitis to determine if sternocostoclavicular hyperostosis can justifiably be classified as a separate entity. All patients underwent one or more bone biopsies to determine the cause of the bone lesion(s).

RESULTS

Seven of the eight patients had involvement of the clavicle. Five of the eight patients had associated distant involvement in the pelvis, femur, tibia, fibula, talus, or sacroiliac joints. Except for predominant localization in the anterior chest wall, the symptoms, the clinical and imaging features, and the results of biopsy and histopathologic examination resemble those of chronic recurrent nonspecific sclerosing osteomyelitis. No skin lesion and no causative organism was found in any of the cases.

CONCLUSION

Sternocostoclavicular hyperostosis is a descriptive term used to designate a form of chronic sclerosing osteomyelitis. Its only distinctive feature is localization on one or more sites of the anterior chest wall.

摘要

目的

本文旨在通过回顾8例此前未发表的儿童病例,阐明胸锁关节骨质增生的临床和放射学特征,明确其与慢性复发性多灶性骨髓炎的相似之处,以及受胸锁关节骨质增生影响的儿童和成人人群之间的差异。适当的影像学检查将避免不必要的诊断和治疗程序。

材料与方法

我们调查了8例儿童(7名女孩和1名男孩)胸锁关节骨质增生的临床和影像学特征,并将这些特征与慢性复发性多灶性骨髓炎和硬化性加雷骨髓炎的特征进行比较,以确定胸锁关节骨质增生是否可合理地归类为一个单独的实体。所有患者均接受了一次或多次骨活检以确定骨病变的原因。

结果

8例患者中有7例累及锁骨。8例患者中有5例伴有骨盆、股骨、胫骨、腓骨、距骨或骶髂关节的远处受累。除主要定位于前胸壁外,症状、临床和影像学特征以及活检和组织病理学检查结果与慢性复发性非特异性硬化性骨髓炎相似。所有病例均未发现皮肤病变和致病微生物。

结论

胸锁关节骨质增生是一个描述性术语,用于指代一种慢性硬化性骨髓炎。其唯一独特的特征是定位于前胸壁的一个或多个部位。

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