short bone diaphyseal tuberculosis
Introduction
Brief introduction of short bone tuberculosis The short bones of the hand, foot and bone are more common, and the patients are mostly children under 10 years old. Adults and the elderly are rare, and the lesions are often frequent. basic knowledge The proportion of illness: 0.001% Susceptible people: mostly children under 10 years old Mode of infection: non-infectious Complications: fracture
Cause
Short bone backbone tuberculosis
(1) Causes of the disease
Mycobacterium tuberculosis is caused by blood circulation invading the short bone backbone.
(two) pathogenesis
Short-bone tuberculosis is mainly caused by hyperplasia, while osteolytic destruction is relatively less. At this time, the main manifestation is that the cortical bone is dilated and thinned, and the medullary cavity is enlarged, and the dead bone is formed more and easily invaded. And joints, when the abscess ruptures to form the sinus, it is easy to secondary mixed infection and pathological changes have the characteristics of suppurative osteomyelitis, the disease in the hands of the first, 2, 3 metacarpal and phalanx incidence is higher In the foot, the first metatarsal and phalanx are multiple.
Prevention
Short bone backbone tuberculosis prevention
Short bone and bone tuberculosis of the hands and feet is more common. Most of the patients are children under the age of 10, adults and the elderly are rare, and the lesions are often frequent. In the early stage of the disease, the local symptoms are more mild; as the disease progresses, the surrounding tissue of the diseased bone gradually swells, and pain and tenderness appear. When invading the joint, the joint may have swelling, pain and limited mobility, and may form a sinus. According to the medical history, clinical findings and X-ray film characteristics, the diagnosis of this disease is more difficult.
Complication
Short bone tuberculosis complications Complications
Sometimes pathological fractures can occur.
Symptom
Short bone backbone tuberculosis symptoms Common symptoms Joint swelling joint swelling joint pain wrist swelling and palm flexion...
In the early stage of the disease, the local symptoms are more mild; as the disease progresses, the surrounding tissue of the diseased bone gradually swells, and pain and tenderness appear. When the joint is invaded, the joint may be swollen, pain and activity are limited, and may form. Sinus.
Examine
Examination of short bone tuberculosis
Because of the short bone trunk tuberculosis, the erythrocyte sedimentation rate often does not increase.
X-ray plain film showed periosteal hyperplasia and new bone formation, while the medullary cavity gradually expanded, the cortical bone expanded and thinned, and there may be dead bone formation, but in the elderly patients, the new bone is not obvious, and sometimes pathological fractures may occur. CT and MRI examinations are required.
Diagnosis
Diagnosis and diagnosis of short bone tuberculosis
According to the medical history, clinical findings and X-ray film characteristics, the diagnosis of this disease is more difficult.
Differential diagnosis
1. Suppurative osteomyelitis: more than a clear history of trauma or a history of soft tissue infection, local red, swollen, hot, painful, and more obvious; acute inflammation characteristics.
2. Gout: The disease is not uncommon in clinical practice, and there is paroxysmal pain. In the attack period, the local skin is red and swollen. X-ray films show worm-like osteolytic destruction at the end of the short tubular bone, but no periosteal reaction. , laboratory tests for blood uric acid higher than 50mg / L.
3. humeral head necrosis: clinically more common in young women around 20 years old, with the second metatarsophalangeal joint swelling and pain as the main symptom, X-ray film shows that the second metatarsal is dense and flat, and there is hyperplasia.
4. Endogenous chondroma: There is no inflammatory symptom in local soft tissue. Although X-ray film shows osteolytic destruction, there is no periosteal reaction, and there is calcification in the tumor.
5. Fatigue fractures: mainly seen after long-distance marching or walking, no signs of soft tissue swelling, more common in military and field operators, X-ray film shows localized periosteal hyperplasia and fracture line of the second metatarsal neck.
6. Fibrosis abnormalities: clinically, it can be found that the main manifestations are soft tissue swelling, X-ray film showing enlarged bone marrow cavity and thinning of cortical bone.
