结核性半身不遂/文胸--肺外结核的一种罕见骨骼形式。

IF 6.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL QJM: An International Journal of Medicine Pub Date : 2025-04-01 DOI:10.1093/qjmed/hcae209
Pradeep Kumar Gunasekaran, Arushi Gahlot Saini, Manish Rohilla
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引用次数: 0

摘要

一名 9 岁女孩的左手食指出现进行性肿胀,疼痛难忍,伴有局部发炎症状,手指活动受限。用针穿刺肿物后,形成了慢性分泌窦。检查发现右侧腮腺部位肿胀,双侧颈部和左侧腋窝淋巴结肿大,左手食指肿胀,近节指骨外侧有慢性分泌窦。Mantoux 皮内注射呈反应性(22x24 毫米压痕)。血液和脓液培养均无菌。手部 X 光片显示有趾骨炎(图 1A-C)。颈淋巴结的精细抽吸和细胞学检查显示有退化的炎症细胞、上皮样肉芽肿和耐酸杆菌。她开始接受四药抗结核治疗(ATT)。随访两个月后,她已无任何症状,左手指的疼痛和肿胀也有所减轻,放射学检查也有明显改善。结核性趾骨炎或 "风帆"(spina ventosa)是指短小的管状骨囊性扩张。它常见于年幼儿童(1 至 6 岁)和成年人(20 至 50 岁)。该病在流行地区的常见表现是单个手指出现无痛、纺锤形肿胀,最常见的是食指或中指的近节指骨,或中指和无名指的掌骨。最早的放射学线索包括骨膜炎,随后是骨质逐渐破坏和腔内囊肿形成,呈现气球样外观。
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Tubercular dactylitis/spina ventosa-a rare skeletal form of extrapulmonary tuberculosis.
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来源期刊
CiteScore
6.90
自引率
5.30%
发文量
263
审稿时长
4-8 weeks
期刊介绍: QJM, a renowned and reputable general medical journal, has been a prominent source of knowledge in the field of internal medicine. With a steadfast commitment to advancing medical science and practice, it features a selection of rigorously reviewed articles. Released on a monthly basis, QJM encompasses a wide range of article types. These include original papers that contribute innovative research, editorials that offer expert opinions, and reviews that provide comprehensive analyses of specific topics. The journal also presents commentary papers aimed at initiating discussions on controversial subjects and allocates a dedicated section for reader correspondence. In summary, QJM's reputable standing stems from its enduring presence in the medical community, consistent publication schedule, and diverse range of content designed to inform and engage readers.
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