Osteitis Dense

Introduction

Introduction to compact osteitis Chronic low back pain caused by thickening of 1-2~2/3 bone density under the humerus of the ankle is called dense osteitis. Occurs in women, 20 to 40 years old and middle-aged women are more common, patients have recurrent low back pain, sometimes can be radiated down to the sides of the hips and thighs, but not root pain, lower waist activity can aggravate symptoms, may be related to pregnancy , strain and focal inflammation. basic knowledge The proportion of illness: 0.003% Susceptible people: 20 to 40 years old and middle-aged women are more common Mode of infection: non-infectious complication:

Cause

The cause of dense otitis

More than 90% of the disease is middle-aged women, especially in late pregnancy, especially after delivery. It can also be seen in the urinary tract or female attachment after chronic infection, or other infections in the pelvic cavity, in the late pregnancy, such as during production, due to endocrine The role of the tendon ligament is often loosened, the ankle joint is loose, and the stability is lost. Therefore, the ankle joint may be subjected to abnormal stimulation or damage, especially the humerus of the ankle joint is more likely to be damaged. It may also be related to physical gravity, chronic strain or trauma.

Prevention

Dense osteitis prevention

First, women should pay attention to rest during pregnancy, do not overwork and protect the lumbar muscles to prevent urinary tract infections.

Second, it is necessary to rest enough after childbirth, it is not appropriate to wear high heels after delivery, so as not to increase the anterior tilt of the pelvis, affecting the blood supply of the iliac bone.

Complication

Dense osteitis complication Complication

The most common cause of this disease is chronic persistent pain in the lower back and can be released to the buttocks and the posterior part of the thigh, but there is no obvious symptom of root pain, but because dense otitis is a disease with self-limiting changes, It will damage the tibia, so there are no reports of other complications in the clinic.

Symptom

Dense sacral inflammatory symptoms Common symptoms Osteoporosis Bone destruction Low back pain

Mainly manifested as low back pain. The pain is generally mild, and there are also asymptomatic or severe pain. Pain is chronic, intermittent soreness and can be exacerbated by an increase in pregnancy or production. Pain in the ankle is mostly one-sided, especially for walking, standing and weight-bearing, but it can be tolerated.

Ankle joint pain and tenderness, most cases of lesions occur in the humerus of both sides of the ankle. The pelvic separation and extrusion test, the "4" test and the Gai test were all positive.

Examine

Examination of dense osteitis

The inspection method used for this disease is mainly X-ray examination:

X-ray findings: the ankle joint anterior film sees the joint space neat and clear, close to the lower 2/3 of the ankle surface, the tibial side of the bone is abnormally dense and uniform, and the trabecular bone texture disappears completely. The edge is clear but no bone destruction, and does not invade the side of the humerus. This lesion is mostly symmetrical. It can also occur on one side. The part can be triangular, crescent-shaped or pear-shaped. The hardened area can be as wide as 3 cm.

Diagnosis

Diagnosis and diagnosis of tight osteitis

diagnosis

1. Past history: The patient is usually in good health and has a history of pregnancy, trauma and pelvic infection.

2. Chief Complaint: The main complaint is low back pain, the pain is generally mild, and there are asymptomatic or severe pain, the pain is chronic, intermittent soreness, and can be aggravated with the increase of pregnancy or production times, ankle pain, 80% is one-sided, especially walking, standing and weight-bearing, but more tolerable.

3. Signs: 1 Ankle joint pain and tenderness, most cases of lesions occurred in both sides of the ankle joint humerus, 2 pelvic separation and compression test, "4" word test and Gai's test were positive.

4. X-ray plain film: no change in the early stage, the posterior display of the humeral surface osteosclerosis, but no bone destruction, the sacral sclerosis of the adjacent ankle joint changes, often involving the distal 1/2 area of the joint, sometimes both sides simultaneously Involved, it is possible that the secretion of relaxin acts on the bone reaction of the pelvic joint before delivery.

Differential diagnosis

The disease is mainly differentiated from osteoarthritis, focal joints, ankle joint tuberculosis, ankylosing spondylitis and suppurative ankle arthritis. The latter two are mostly affected by one side of the joint. Very rare.

1. Ankylosing spondylitis (AS)

Ankylosing spondylitis is almost 100% invading the ankle joint. The typical X-ray is a significant stenosis of the joint space. The articular surface is serrated, with localized osteoporosis, and the lumbar spine is bamboo-like, but the humerus is not obvious. Regular osteosclerosis zone.

2. Ankle arthritis (OA)

OA is a non-inflammatory degenerative disease mainly characterized by hyperosteogeny. The X-ray shows the formation of callus below the auricular surface of the humerus, but the joint surface is clear and there is no increase in triangular bone density.

3, ankle joint tuberculosis

The incidence of ankle joint tuberculosis is not limited to the axillary ear surface, there may be progressive bone destruction, bone hardening rarely occurs, and the ankle joint is blurred due to edge destruction, mostly unilateral onset.

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