sclerosing osteomyelitis
Introduction
Introduction to sclerosing osteomyelitis Sclerosing osteomyelitis, also known as Garre osteomyelitis, Garre's disease, idiopathic cortical sclerosis and dry osteomyelitis, is less common. The cause has not been completely determined. It is generally considered to be a low-toxic infection of bone-published tissue, and has a strong osteogenic reaction. It is also believed that there are multiple small abscesses in the bone tissue at the same time, and the tension is high; the disease mostly occurs in the long tubular bone backbone. Take the tibia as a good site. The cause has not been completely determined. It is generally considered that the bone is a tissue with low toxicity and has a strong osteogenic reaction. It is also believed that there are multiple small abscesses in the tissue of the osteopath. basic knowledge Sickness ratio: 0.0001% Susceptible people: no special people Mode of infection: non-infectious Complications: bone hyperplasia
Cause
Cause of sclerosing osteomyelitis
Low toxicity infection of bone tissue (35%):
It is generally considered to be caused by low toxicity of bone tissue. It has a strong osteogenic reaction and is characterized by thickening of cortical bone. It is also believed that there are multiple small abscesses in the bone tissue, the tension is high, and the bacterial culture is mostly negative. This disease occurs mostly in the backbone of long tubular bone, with the tibia as a good site.
Extensive fibrosis of the medullary cavity (26%):
The disease is progressive, extensive and sclerosing inflammation of the bone. Extensive fibrosis occurs in the bone marrow cavity due to inflammatory reaction, promoting bone subendothelial tissue hyperplasia, deposition and calcification, and Haser tube obstruction occurs in reactive bone. The membrane is thickened, and the cortical bone is a series of pathological changes such as fusiform hyperplasia. Unlike general suppurative osteomyelitis, it does not produce abscesses, dead bones, and fistulas. There are a few wounds that may have some pus and granulation tissue, and culture may have S. aureus growth.
Prevention
Sclerosing osteomyelitis prevention
The cause of this disease is unknown, so there is no effective preventive measures at present, but it should be noted that for the treatment of this disease, conservative treatment can only temporarily relieve symptoms, and the use of thorough removal of the lesion and recanalization of the medullary cavity is an effective and preventive treatment. And the prognosis is good. Life temperance pay attention to rest, work and rest, life orderly, maintain optimistic, positive, upward life attitude to make tea and rice regular, living and living often, not overworked, cheerful, and develop good habits. Avoid alcohol and tobacco.
Complication
Sclerosing osteomyelitis complications Complications
The disease is prone to cause long-term chronic inflammation, while long-term chronic inflammation stimulates bone hyperplasia, bone tissue ischemia, hypoxia, or even stenosis or occlusion of the medullary cavity, while occlusion of the medullary cavity is a serious obstacle to blood circulation of the bone, increasing bone Internal pressure, so that the bone's resistance is lower, forming a vicious circle, so that the disease is prolonged and healed, repeated attacks, seriously affecting physical health and labor capacity.
Symptom
Sclerosing myeloinflammation symptoms Common symptoms Brow arch depression Bone destruction Cortical membrane reaction Dead bone pain Lack of bone sclerosis
This disease occurs in a large number of children and adults, often invading the long bones such as the humerus, humerus, ulna, etc., sclerosing osteomyelitis is a chronic disease onset, the incidence is faint, the systemic symptoms are mild, often due to local pain and discomfort And the treatment, often repeated attacks, local pain can be found during the examination, tenderness and high skin temperature, rarely redness, and more rare to wear skin, the symptoms can be relieved after using antibiotics, can touch the thickening of the backbone after multiple episodes .
Examine
Sclerosing osteomyelitis
White blood cells can be elevated during acute attacks, and erythrocyte sedimentation rate can be increased.
X-ray films showed that the main part of the backbone was fusiform and thickened, and the bone density increased. Because the X-ray film showed large white shadows, it was difficult to see the narrow bone marrow cavity and small translucent area, or the irregular bone density reduction area. Layer film and CT examination can detect small translucent areas that are difficult to distinguish from ordinary X-ray films.
Diagnosis
Diagnosis and identification of sclerosing osteomyelitis
diagnosis
According to the age of onset, location, clinical manifestations and X-ray films, CT examination can establish a diagnosis.
X-ray films can be seen on a large number of bone dense hyperplasia, because the X-ray film shows a large white shadow of the paper, it is difficult to see the narrow marrow cavity and small translucent area. Layered film and CT examination can detect small translucent areas that are difficult to distinguish from ordinary X-ray films. There was no abnormal manifestation within 1 month at the beginning of the disease. The long-term thickening of the cortical bone showed dense, hardened, no obvious boundary with normal bone. The bone marrow cavity was narrower or occluded than normal, indicating that the medullary endocardium also had hyperplasia and new Bone formation.
Differential diagnosis
(A) sclerosing osteosarcoma: occurs in adolescents, found in the metaphysis but not in the backbone, with radial hyperplasia and periosteal triangle. Delayed treatment can lead to lung metastasis.
(B) Ewing's sarcoma: The patient is younger, the course of disease is developing rapidly, and it seems to be acute suppurative osteomyelitis. There is high fever, chills, severe pain, and high serum AKP values. X-ray films showed that the cortical bone was changed by onion skin, and the bone marrow cavity was damaged and enlarged.
(C) osteoid osteoma: On the upper end of the backbone, the cortical bone proliferates, with a small translucent area in the middle, which is nested.
(D) syphilitic osteitis: blood Hua Kang positive, painless, multiple bone hyperplasia, bilateral symmetry.
(5) Orthopedic osteitis: Also known as Paget disease, it occurs in the elderly, multiple, and lower extremities, the bone becomes thick and curved. The course of the disease progresses slowly, the pain is not severe, and there may be local hypothermia. X-ray films showed thickening of the cortical bone, enlarged medullary cavity, disordered and irregular trabecular bone texture, compensatory thickening in the convex side bone, increased serum AKP value, and normal blood calcium.
