Karim Mostafa, Carmen Wolf, Matthias Bürger, Sebastian Kapahnke, Thorben Michaelis, Rouven Berndt, Rene Rusch, Julian Andersson, Philipp Jost Schäfer
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引用次数: 0
摘要
一名66岁女性,因蓝趾综合征(BTS)和左大脚趾骨炎的迹象而在急诊室就诊。外周血管影像学检查未见明显病变。有创血管造影显示距舟关节处足背动脉(DPA)严重局灶性狭窄。踝关节背侧伸展可诱导狭窄完全消退。进一步的影像学显示潜在的距舟关节半脱位是动脉受压的原因。DPA卡压是一种罕见的疾病,最常被描述为与结缔组织带或变异肌肉肌腱有关(McCabe等人70:213- 8,2021;Weichman et al. 24:113, 2010;[j] .科学通报,2013;Griffin et al. 20:325-8;2012)。在本病例中,由于颅骨距骨半脱位导致的PDA骨压迫被认为是导致BTS和第一趾指骨炎的原因。
Functional bony entrapment of the dorsalis pedis artery caused by cranial subluxation in the talonavicular joint.
A 66-year-old female presented in the emergency department with Blue-Toe-Syndrome (BTS) and signs of osteitis of her left big toe. Imaging workup of the peripheral vasculature showed no findings. Upon invasive angiography, severe focal stenosis of the dorsalis pedis artery (DPA) could be seen at the talonavicular joint. Complete regression of the stenosis was inducible by dorsal extension in the ankle joint. Further imaging revealed an underlying subluxation of the talonavicular joint as cause of the arterial compression. Entrapment of the DPA is a rare condition and most often described in relation to connective tissue bands or variant muscular tendons (McCabe et al. 70:213-8, 2021; Weichman et al. 24:113, 2010; Smith et al.58:212-4, 2013; Griffin et al. 20:325-8; 2012). In the presented case, bony compression of the PDA due to cranial subluxation of the talus was seen as the cause of BTS and osteitis of the phalanx of the first toe.