骨旁脂肪瘤伴有骨质异常的CT表现

目的 研究骨旁脂肪瘤伴有骨质异常(骨软骨瘤或骨突)的CT表现特点,提高对该病的认识及鉴别诊断能力.方法 回顾性分析经手术和病理证实的6例骨旁脂肪瘤伴有骨质异常的CT平扫和临床资料.结果 6例骨旁脂肪瘤伴有骨质异常的患者中2例合并骨软骨瘤,4例合并骨突,CT均可清楚显示骨旁脂肪瘤及其下方的骨质改变.2例合并骨软骨瘤患者中1例病变位于坐骨,1例位于股骨粗隆;4例合并骨突患者中2例位于股骨干,1例位于胫骨干,1例位于胸骨.骨软骨瘤和骨突紧紧附着于其下方的骨质,大小为0.3 cm×1.2 cm～6.0 cm x4.0cm.2例骨软骨瘤较大,呈菜花状,骨皮质与其下方附着骨的骨皮质相连续,骨髓腔与附着骨的骨髓腔相通.4例骨突较小,形态不同,其中2例为单个小的骨突,另2例可见2～4个骨突.骨软骨瘤和骨突被脂肪瘤包绕,脂肪瘤大小为3.0 cm x2.0 cm～11.0 cm×10.0 cm,其内可见厚薄不均匀、数日不等的纤维间隔,肿块边缘清楚锐利.1例脂肪组织内可见钙化和(或)骨化,2例可见肌肉萎缩.结论 CT平扫可以清楚显示骨旁脂肪瘤合并骨软骨瘤或骨突的形态、部位和范围,并清楚显示与其下方骨质的关系,对两者进行鉴别诊断,并为外科手术提供重要信息.     

原发性骨淋巴瘤全身骨显像及PET／CT检查一例

患者女，26岁，因“发现左侧胸背部包块8年，背部疼痛2个月，双下肢感觉、运动障碍2周”入院。体格检查左侧胸背部（其中心大致位于左侧腋后线平胸9椎体水平）一8cm×6cm包块突出皮面，局部皮肤完整，包块边界清晰，活动度差，质地稍硬，无压痛。     

少见距骨骨软骨瘤1例

1 病历简介 患者，男，10岁。因发现有外踝下方包块，并渐进性增大5年。患者5岁时，父母即发现其右外踝下方一骨性包块，无压痛，不影响行走，未作特殊处理。5年来包块逐渐增大，并影响行走，近来出现右外踝酸痛不适并跛行而入院就诊。无家族遗传病史及外伤史。体格检查：生命体征平稳，神志清楚，头颅、五官、心、肺、腹部检查未发现异常。发育正常。     

耻骨骨软骨瘤一例

患者　女 ,5 0岁。发现会阴左侧隆起 10年余 ,逐渐增大 ,偶有酸痛感。体检 :会阴左侧相当于左耻骨水平见一约4 .0cm× 5 .0cm大小包块 ,界限清楚 ,质地坚硬 ,无活动性 ,轻压痛 ,皮温不高 ,表面光整。骨盆挤压 (分离 )实验 (- )。X线表现 :左侧耻骨联合处可见约 3.0cm× 4 .0cm大小骨化影 ,密度不均 ,其中见不规则透亮区 ,外缘边界清晰 ,基底部较宽 ,与耻骨皮质骨相连 ,无骨膜反应 ,未见软组织肿块影 (图 1)。X线诊断 :骨软骨瘤。CT表现 :于左侧耻骨联合处向前生长的骨性突起 ,形如菜花状 ,基底部与耻骨皮质相连 ,内有松质骨 ,边界清 ,内有…     

骨斑点病1例

患者 男,20岁。因外伤后4天左髋部及臀部肿痛来我院就诊,予以左髋部CT扫描。 CT检查显示：双侧股骨头、股骨颈及双侧耻骨上下支松质骨内可见散在数量不等的圆形、椭圆形及条状致密影（图1～3）,长轴与骨长轴平行（图4）。患者左侧臀大肌与下肌间可见条状混杂密度灶（图5）。     

腕舟状骨骨折5例误诊分析

20 0 0年 4月— 2 0 0 3年 1月 ,我们收治腕舟状骨骨折11例 ,误诊 5例 ,误诊率为 4 5 .5 %。现将误诊原因分析如下 :1　临床资料1.1　一般情况　本组男 4例 ,女 1例 ;年龄 12 6 6岁 ,平均2 3岁。损伤原因 :绞轧伤 1例 ,跌打伤 4例 ;左侧 1例 ,右侧4例。骨折类型 :开放性骨折 1例 ,闭合性骨折 4例 ;误诊时间 :ld6个月 ;5例均误诊为腕部软组织伤。1.2治疗和结果　 1例绞轧伤急诊手术因漏诊 4个月行腕关节融合术。 3例新鲜骨折确诊后给予管型石膏固定 3个月 ,痊愈。l例骨不连行桡骨茎突切除术。2　分析与讨论　　根据腕部外伤史 ,腕关节活动受…     

石骨症合并骨肉瘤一例报告

石骨症系一种少见的骨骼发育异常,而合并骨肉瘤者尤为少见,我院遇到一例,报告如下: 女性,33岁.左侧大腿于半年前在挑水中被扁担压了一下,后逐渐肿痛,并出现跛行.又于三个月前.因上     

肋骨多发性骨脂肪瘤一例

患者　女,6 5岁。主诉双侧胸背部疼痛半年余。体检:脊柱向右略侧弯,胸廓不对称。右侧胸部腋后线第6、7肋处、左侧胸部腋后线内侧第7、8肋处隆起,可触及包块,质地较硬,无活动,压痛明显。周身浅表淋巴结无肿大,实验室检查无阳性发现。左、右斜位X线片示:右侧第7后肋及左侧第8后肋外段见一分别为4 .0cm×2 .0cm、6 .0cm×2 .5cm膨胀性骨质图1、2　左、右侧切线位:示右第7肋后肋、左第8后肋外侧段呈椭圆形膨胀性改变,囊壁边界清晰硬化,内有残留之骨小梁破坏,其内均见残留骨小梁,骨皮质变薄,病灶边缘均有粗细不均的硬化缘,与正常肋骨分界清楚(图…     

髋臼骨软骨病一例报告

本病为一种少见的先天骨骼发育异常。国内仅见曹氏综合报道11例。现将我们遇到的一例报告于下: 女,11岁.1981年底出现两髋关节疼痛,走路跛行,下蹲困难,左侧明显,时轻时重。不发热,无外伤和结核史.在新生儿期,臀部曾因注射青霉素而感染,切开治疗。此后一般情况甚好.检查:营养发育较好,     

腹膜后恶性纤维组织细胞瘤骨显像阳性一例

患者男,54岁,因左中上腹反复胀痛2年入院。体格检查：左中上腹明显隆起,可触及直径13cm、质硬、压痛、表面欠光滑、不移动肿块,叩诊肿块呈实音,肝脾肋下未触及,移动性浊音阴性,其余各系统无异常。美国GE—high speed-8层螺旋CT平扫示：胰尾部后下方、左肾前方、脊柱左侧腰大肌前可见一形态不规则肿块影,大小约114mm×73mm×150mm,其内密度不均匀;增强扫描后肿块明显强化,肿块下面部分内侧低密度影未见强化,     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.