硫胶体成像在区分夏科神经性关节病和骨髓炎方面的实用性:病例研究。

IF 0.5 4区 医学 Q4 ORTHOPEDICS Journal of the American Podiatric Medical Association Pub Date : 2024-03-01 DOI:10.7547/21-235
Christopher M Gill, Mark J Bullock, Andrew H Cohen
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引用次数: 0

摘要

夏科神经性关节病和骨髓炎的初期表现可能相似。区分这两种病理状态的能力至关重要,因为每种病理状态需要不同的治疗方法。我们介绍了一例 53 岁女性的病例,她的左侧第一跖趾关节和第一跗跖关节疼痛、肿胀和发热。X 光片显示第一跖骨基部有粉碎性骨折。根据体格检查结果和既往第一跖趾关节关节置换术史,主治团队怀疑她患有骨髓炎。三相骨扫描和铟白细胞扫描显示骨髓炎阳性。足科医疗团队根据患者的体格检查结果和之前关节置换术时未控制的血糖水平,怀疑她可能患有 Charcot 神经关节病。他们进行了胶体硫扫描,并与铟扫描进行了比较,结果显示没有骨髓炎的迹象。该病例表明,与铟白细胞扫描相比,硫胶体成像有助于区分骨髓炎和夏科神经性关节病。本病例还强调了利用临床判断做出正确诊断的重要性。
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The Utility of Sulfur Colloid Imaging to Differentiate Charcot's Neuroarthropathy from Osteomyelitis: A Case Study.

Charcot's neuroarthropathy and osteomyelitis can have similar initial presentations. The ability to differentiate between the two pathologic conditions is essential, as each requires different treatment. We present a case of a 53-year-old woman with pain, swelling, and warmth in her left first metatarsophalangeal joint and first tarsometatarsal joint. Radiographs showed comminuted fractures at the base of the first metatarsal. Osteomyelitis was suspected by the primary team based on physical findings and a history of previous first metatarsophalangeal joint arthrodesis. A triphasic bone scan and an indium white blood cell scan were positive for osteomyelitis. The podiatric medical team was suspicious for possible Charcot's neuroarthropathy based on physical findings and uncontrolled blood glucose levels at the time of her previous arthrodesis. A sulfur colloid scan was performed and compared with an indium scan, which showed no evidence of osteomyelitis. This case demonstrates the usefulness of sulfur colloid imaging compared with an indium white blood cell scan to differentiate osteomyelitis from Charcot's neuroarthropathy. This case also highlights the importance of using clinical judgment to make the correct diagnosis.

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来源期刊
CiteScore
1.10
自引率
0.00%
发文量
128
审稿时长
6-12 weeks
期刊介绍: The Journal of the American Podiatric Medical Association, the official journal of the Association, is the oldest and most frequently cited peer-reviewed journal in the profession of foot and ankle medicine. Founded in 1907 and appearing 6 times per year, it publishes research studies, case reports, literature reviews, special communications, clinical correspondence, letters to the editor, book reviews, and various other types of submissions. The Journal is included in major indexing and abstracting services for biomedical literature.
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