股骨近端骨样骨瘤误诊原因分析

Analysis of misdiagnosis of osteoid osteoma in the superior femur

  • 摘要: 目的: 分析骨样骨瘤的症状、体征及X线特点,减少该病的误诊误治率。方法: 回顾分析经手术病理证实的骨样骨瘤9例。男7例,女2例。归纳所有病例的症状、体征、X线及CT检查特点。结果: 全部9例患者均有患侧髋关节持续疼痛夜间加重的特点,及由此所致的跛行和患侧大腿肌肉萎缩的体征。骨样骨瘤的影像学表现为一圆形或卵圆形的透亮区,直径<2cm,其周围有不同程度的骨质硬化。9例X线平片仅5例发现不规则密度减低区,9例CT均清楚显示病灶瘤巢;1例MRI也观察到类似瘤巢的改变。4例同位素检查均表现为病变区核素浓聚现象。结论: 疼痛是骨样骨瘤的主要症状,瘤巢是确诊骨样骨瘤的关键,CT是发现瘤巢的最佳方法。误诊原因是缺乏对该病的认识。

     

    Abstract: Objective: To reduce the misdiagnosis rate of osteoid osteoma by analyzing its symptoms,signs,and X-ray findings. Methods: Nine cases of osteoid osteoma(7 males and 2 females) confirmed by histopathology were chosen.All patients underwent plain X-ray examination and CT scanning,and one of them had MRI. Results: All cases had persistent night pain in the hip joints,which caused symptoms of limp and muscular atrophy in the affected leg.The osteoid osteoma was found to have a circular or oval radiolucency(nidus) which was less than 2 cm in diameter with different degrees of bone sclerosis around the nidus.Of the 9 cases,5 showed an irregular area with less density on plain X-ray film.CT scanning showed nidus in all cases.MRI showed nidus in 1 case.Radioactive scanning showed radioactive concentration in 4 cases. Conclusion: Pain is the main symptom and nidus is the key to the diagnosis of osteoid osteoma.CT scan is the best method to demonstrate the nidus.The reason why osteoid osteoma is misdiagnosed is lack of knowledge about the disease.

     

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