早发型先天性骨梅毒的X线表现

目的分析早发型先天性骨梅毒的X线表现，提高对本病的认识。资料与方法搜集30例早发型先天性骨梅毒患儿的骨骼X线片和临床资料，分析其X线表现。结果早发型先天性骨梅毒的X线表现主要包括：(1)四肢长骨对称性的干骺端炎、骨膜炎和骨干炎。干骺端炎主要表现为临时钙化带增浓、模糊或增宽，骨质破坏和骨质缺损；骨膜炎主要表现为骨膜增厚；骨干炎表现为虫蚀状骨质破坏。30例中干骺端炎29例，骨膜炎12例，骨干炎3例。(2)其他如髂骨、锁骨、椎骨、肩胛骨和手足小骨均有干骺炎或骨皮质下透亮带和皮质虫蚀样破坏，以髂骨(10／23)和手足小骨(17／27)改变最为常见。(3)6例有四肢软组织肿胀，为对称性，其程度与骨破坏不一致。结论早发型先天性骨梅毒X线表现有一定特征性，可作为先天性梅毒的诊断手段之一，对诊断为先天性骨梅毒的患儿，应常规行四肢长骨及骨盆和手足等X线摄片。

Radiographic Findings of Early Congenital Skeletal Syphilis

Objective To explore X-ray manifestations of bone and joint in early congenital syphilis.Materials and Methods X-ray manifestations and clinic data of 30 patients with early congenital syphilis were retrospectively reviewed. Results The radiographic findings of early attacking congenital syphilis of bone are composed of three parts: (1)Extremities: extensive, symmetrical and multiple metaphysitis, periostitis and osteomyelitis. Metaphysitis was shown as widen and bluring of temporary calcification strip, osteolytic and defect, periostitis was shown as thicken of periosteal, osteomyelitis was shown as osteolytic. (2)Other bones: iliac (10/23) and small bones of hands and feet (17/27) were most commonly involved with metaphysitis or osteolytic. (3)Soft tissue: 6 cases were shown symmetrical soft-tissue swell disproportionable to bony destruction.Conclusion Radiographic findings of bone and joint in early congenital syphilis have some characters, X-rays of extremities, pelvis and hand or feet can be regarded as a conventional method for diagnosis.