metacarpophalangeal tuberculosis
Introduction
Introduction to metacarpophalangeal tuberculosis The phalange tuberculosis and metacarpal tuberculosis are collectively referred to as the short bone bone tuberculosis. The incidence rate is secondary to the upper limb bone and joint tuberculosis, which is only lower than the elbow joint tuberculosis, accounting for 4.88% of the body bone and joint tuberculosis. Patients are mostly children, and adulthood is rare. basic knowledge The proportion of the disease: the incidence rate is about 0.001% -0.002% Susceptible people: no specific population Mode of infection: non-infectious Complications: abscess
Cause
Metacarpophalangeal tuberculosis
Causes:
Palm, tuberculosis of tuberculosis caused by the blood source.
Pathogenesis
The pathological changes of the main tuberculosis are mainly hyperplasia, followed by osteolytic destruction, and the formation of dead bone is rare. The short bones of the hand are also mainly hyperplasia, and the formation of dead bone is sometimes seen. The pathological changes and the long bones are slightly Different, there are common changes in gas sputum, that is, bone swelling and thinning, the medullary cavity is enlarged due to osteolytic destruction, and the formation of dead bone is more than that of long bones. It may be due to the small size of the bone, and the chance of the lesion easily affecting the joint. There are many long bone tuberculosis, and the incidence of short tubular bone tuberculosis is much higher than that of long bone. Considering that the muscle around the short tubular bone is small or absent, it lacks the protective effect of muscle. In addition, the nutrient vessels of the short tubular bone are more Fine, slow blood flow, bacterial emboli is easy to stay in the local area and cause disease. In the metacarpal tuberculosis of the hand, the number of cases of metacarpal bone is higher than that of the phalanx, and the distal phalanx is rare. Among the 5 fingers, 1, 2 3 refers to the higher prevalence rate of the metacarpal and phalanx, 4, 5 refers to the palm, and the prevalence of the phalanx is lower.
Prevention
Metacarpal tuberculosis prevention
BCG vaccination
Vaccination with BCG has a significant effect on the prevention of hematogenous disseminated tuberculosis in infants and children with cellular insufficiency, miliary tuberculosis and tuberculous meningitis. Strict implementation of the BCG vaccination system has a positive effect on reducing tuberculosis and extrapulmonary tuberculosis in infants and children.
Tuberculosis patient contact prevention
Pulmonary tuberculosis patients should follow the doctor's advice to take the medicine regularly. Generally, the infection is reduced by 95% after 2 weeks of regular treatment. The contact person of tuberculosis patient can go to the tuberculosis prescription unit for examination to rule out the possibility of illness. At the same time, do the following precautions:
Do a thorough disinfection. According to the characteristics of cold, heat and dry heat resistance of tubercle bacilli, boiled dishes, towels, clothes, handkerchiefs, masks and other items used by patients for 10 to 15 minutes; for books, quilts, chemical fiber clothing, etc. Cooked items can be exposed to sunlight for 4 to 6 hours or UV light for two hours. In addition, it can also be used for disinfection of disinfectant such as Sushui. The room where the patient lives can be sterilized by ultraviolet light.
Temporarily open the window to ventilate and keep the indoor air fresh. According to statistics, ventilation is ventilated every ten minutes, and after 4 to 5 times, 99% of Mycobacterium tuberculosis in the air can be blown off.
Cultivate good hygiene habits, such as the implementation of the system of food, the special equipment for washing utensils, washing hands frequently, changing clothes frequently, and disinfecting regularly.
Drug prevention
Strong positive tuberculin test (+ + + +), contact with open tuberculosis patients, silicosis patients, hemodialysis patients with renal disease, diabetic patients, long-term use of adrenal cortical hormone patients, in order to eliminate the more active dormant tuberculosis, available Isoniazid oral (1 mg/kg for adults and 10 mg/kg for children) for 1 year to reduce the chance of tuberculosis recurrence.
Complication
Metacarpophalangeal tuberculosis complications Complications
The sinus is formed after the abscess collapses.
Symptom
Metacarpal tuberculosis symptoms common symptoms bone gas sputum long bone swelling pain abscess bone destruction
Does not combine other parts of the tuberculosis of the hand, phalanx tuberculosis, generally no obvious systemic symptoms, early local local swelling, local swelling is obvious, the pain will increase, if the lesion breaks into the skin, the skin can be red, dark, due to The local soft tissue is thin, and sometimes the abscess ruptures to form the sinus.
Examine
Examination of metacarpophalangeal tuberculosis
X-ray films can be seen in the affected metacarpophalangeal bone with new periosteal bone formation, thickened cortical bone, enlarged bone marrow cavity, spindle-shaped swelling, or formation of bone sputum, a few cases can appear dead bone, the elderly new bone proliferation obvious.
Diagnosis
Diagnosis and differentiation of metacarpal bone tuberculosis
Diagnosis can be made based on medical history, clinical symptoms, and X-ray films.
X-ray film can be seen in the affected metacarpophalangeal bone with new periosteal bone formation, thickened cortical bone, enlarged bone marrow cavity, spindle-shaped swelling, or formation of bone gas sputum (Figure 1), a few cases can appear dead bone, the elderly New bone hyperplasia is not obvious.
Sometimes it needs to be differentiated from suppurative osteomyelitis, endogenous chondroma, etc.
