diaphyseal tuberculosis
Introduction
Introduction of long bones and tuberculosis Tuberculosis of longboneshaft is rare, and the order of the disease is femur, humerus, ulnar shaft, humeral shaft and humeral shaft. Children under the age of 10 are the most frequent and often frequent, and those over the age of 30 are rare. basic knowledge The proportion of illness: 0.001% Susceptible population: Most children under 10 years old Mode of infection: respiratory transmission Complications: tuberculosis, bone tuberculosis
Cause
Long bone backbone tuberculosis
(1) Causes of the disease
Mycobacterium tuberculosis is caused by blood stasis invading the long bones.
(two) pathogenesis
The pathological changes of long bone tuberculosis mainly include periosteal hyperplasia and new bone. The osteolytic destruction is relatively rare, and the formation of dead bone is rare. Because the muscles around the backbone are rich, the pus is absorbed once it appears, so few sinuses are formed. In addition, osteolytic destruction occurs in the medullary cavity, occasionally in the new bone, and can be single or multiple. Because the bone tuberculosis is far from the tarsal plate and the joint end, it has bone growth and joint function. Generally no significant impact.
Prevention
Long bone backbone tuberculosis prevention
1) Eliminate the source of infection Establish a monitoring network for tuberculosis, find patients in time, actively and thoroughly treat, and quickly control the source of infection. Although effective chemotherapy can take several months to make the sputum negative, it can reduce the infectivity of the patient to almost disappear within 2 weeks.
2). Protecting susceptible populations BCG vaccine is the most effective way to prevent tuberculosis. The newborn is vaccinated at birth and will be replanted every 5 years until 15 years old. BCG vaccination has two methods: scratch method and intradermal injection. In adolescents, those who are positive for the sputum test can be treated with INH chemically, 300 mg daily for six months to one year.
Complication
Long bone tuberculosis complications Complications, tuberculosis, tuberculosis
Often complicated by tuberculosis or other bone tuberculosis.
Symptom
Long bones, tuberculosis symptoms, common symptoms, children do not dare to sleep, abscess
In children, there are many lesions and several long bones, often complicated by tuberculosis or other bone tuberculosis. Patients have obvious systemic symptoms. The systemic symptoms of single cases are not obvious, local symptoms are mild, and early, local pain and swelling are not obvious. However, there is local tenderness. A careful palpation can reveal that the backbone is thick, pus flows into the soft tissue, forming a cold abscess, but few sinus formation.
The joints maintain a good function, or only a slight restriction. Only when the lesion develops invading the joint to the bone end, the joint causes swelling and functional limitation. The lower extremity bone tuberculosis patients are less obvious.
Examine
Long bone tuberculosis examination
The erythrocyte sedimentation rate can be increased.
1. X-ray plain film is mainly for X-ray plain film examination. There may be new bone formation around the diseased bone, which is mostly onion-like hyperplasia. There may be osteolytic lesions in the new bone or medullary cavity, which is single or Multiple, more common in oval, but dead bones are rare, tuberculous periostitis only localized periosteal hyperplasia without associated with signs of destruction.
2. Other imaging examinations generally do not need CT and MRI examinations, unless the lesions are used for differential diagnosis early.
Diagnosis
Diagnosis and diagnosis of long bone tuberculosis
According to the clinical manifestations and accompanying other parts of the tuberculosis, the disease can be diagnosed by combining X-ray findings.
Differential diagnosis
The diagnosis of single cases is more difficult, and it is generally necessary to identify the following diseases.
1. Chronic localized suppurative osteomyelitis The systemic symptoms of this disease are slightly more obvious than tuberculosis, and the local area is prone to sclerosing changes. When it is difficult to identify, it is necessary to make a difference between bacteriological examination and pathological biopsy.
2. Eosinophilic granuloma patients with eosinophilia in the blood, X-ray film can show the destruction of the medullary cavity and the disappearance of the cortical bone, as well as the surrounding of the lesion with new bones, etc., but the diagnosis still requires pathological examination.
3. Ewing sarcoma This disease is a malignant tumor, the incidence is acute, the symptoms and signs are very obvious, X-ray plain film shows that the diseased bone is osteolytic destruction, and may be accompanied by periosteal hyperplasia and new bone formation, sometimes can be onion skin Appearance, but there is no obvious boundary with the surrounding soft tissue, the diagnosis depends on pathological examination.
