颈部骨化性肌炎多次误诊一例诊疗反思

目的 探讨骨化性肌炎的临床特点,以减少误诊误治.方法 对我院收治的1例多次误诊的骨化性肌炎的临床资料进行回顾性分析.结果本例因颈部疼痛伴活动受限就诊,初诊为寰枢椎半脱位,入院后又按颈部脓肿、结核性病变予抗感染和试验性抗结核治疗均无效.2次经皮穿刺活检分别诊断为慢性肌炎、神经源性肿瘤,行肿物探查切除术,术中见颈部肌纤维色泽、质地无明显异常,局限性肿块,无包膜,有骨化碎片,连同部分肌纤维完整切除,术后病理诊断为骨化性肌炎,患者恢复良好.结论脊柱部位的骨化性肌炎较少见,临床接诊颈部肿物者需将临床、影像学和病理检查资料综合分析,以减少骨化性肌炎的误诊误治.

Diagnosis and Treatment of One Repeatedly Misdiagnosed Patient with Cervical Myositis Ossificans

Objective To investigate the clinical features of myositis ossificans in order to avoid misdiagnosis and mistreatment.Methods Clinical data of one repeatedly misdiagnosed patient with myositis ossificans was retrospectively analyzed.Results The patient was admitted for cervical pain and limitation of activity,and diagnosed as having atlantoaxial subluxation at the preliminary diagnosis.After admission noneffective therapies of anti-infection and trial anti-tuberculosis were given for suspicion of cervical abscess and tuberculous lesions.The patient was diagnosed as having chronic myositis and neurogenic tumors respectively by the results of two tests of percutaneous puncture biopsy.No obviously abnormal color and texture of neck muscle fiber,localized masses without peplos and ossification fragments were found during the exploration and tumor resection,and all masses and ossification fragments together with part of muscle fibers underwent complete resection.Postoperative pathological diagnosis was myositis ossificans,and the patient recovered well.Conclusion Myositis ossificans in spine area is rare,so patients with neck masses should be comprehensively diagnosed with results of clinical,radiological and pathological examinations in order to avoid misdiagnosis and mistreatment.