米诺环素诱发的足踝外科黑骨病:病例报告。

IF 0.5 4区 医学 Q4 ORTHOPEDICS Journal of the American Podiatric Medical Association Pub Date : 2024-03-01 DOI:10.7547/23-091
Arij M Rashid, Timothy P Cheung, Rumzah Paracha, Glenn C Vitale, Steven D Vyce
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引用次数: 0

摘要

背景:骨和关节周围组织变色可能是一个意想不到的发现,通常会让外科医生感到不安,并可能改变手术计划和对患者的整体管理。骨变色的常见原因包括感染、血管性坏死和骨炎。米诺环素诱发的黑色骨病是足踝外科手术中遇到的一种罕见且相对良性的异常情况,可导致骨骼出现明显的黑色、蓝色和灰色变色:在一次前足择期手术中,术中意外发现弥漫性黑色、蓝色和灰色骨变色,这引起了对代谢恶性过程的担忧,并促使将第一跖趾关节植入关节成形术计划改为凯勒关节成形术计划。较小指骨的近端指间关节假体植入计划按计划继续进行。骨标本被送去进行病理分析:术后分析发现,患者长期使用米诺环素治疗寻常痤疮。标本的病理分析排除了恶性过程。根据现有数据,诊断结果为米诺环素诱发的黑骨病。自上次随访以来,患者愈后良好,未出现并发症:我们的病例报告强调了将长期使用四环素类药物纳入术前病史的重要性,这有助于外科医生在术中做出决策。
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Minocycline-Induced Black Bone Disease in Foot and Ankle Surgery: A Case Report.

Background: Bone and periarticular tissue discoloration can be an unexpected finding that is often disconcerting for surgeons and may alter surgical plans and overall patient management. Common causes of bone discoloration include infection, avascular necrosis, and bone inflammation. Minocycline-induced black bone disease is a rare and relatively benign abnormality encountered in foot and ankle surgery that can cause significant black, blue, and gray discoloration of bone.

Methods: Unanticipated intraoperative findings of diffuse black, blue, and gray bone discoloration during an elective forefoot operation raised concern for a metabolically malignant process and prompted the conversion of plans for a first metatarsophalangeal joint implant arthroplasty to a Keller arthroplasty. The plan for proximal interphalangeal joint arthroplasties of the lesser digits were continued as planned. Bone specimens were sent for pathologic analysis.

Results: Postoperative analysis identified chronic use of a minocycline for acne vulgaris. Pathologic analysis of the specimens ruled out malignant processes. Altogether, the data available led to the diagnosis of minocycline-induced black bone disease. Since the last follow-up, the patient has healed well without complications.

Conclusions: Our case report underscores the importance of including the chronic use of tetracyclines in medical history intake during preoperative visits to assist the surgeon in intraoperative decision-making.

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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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