血友病性骨关节病1例

患者男性，16岁，因下肢进行性疼痛3年余入院，以右下肢明显，无发热等症状。查体：右膝关节肿胀、僵直。X线检查：右膝关节间隙明显变窄，关节面平坦，软骨下骨质可见大小不等的囊状骨质破坏，髁间凹变深增宽，诊断为血友病性骨关节病。     

亚历山大病误诊为脑炎1例

患儿男,2岁,因“抽搐4次,运动倒退3月余”入院.查体:左眼向左斜视,左侧面部抽动,肢体僵硬,意识丧失.脑脊液检查:蛋白201.1 mg/L,血糖3.4 mg/L,白细胞7×109/L,氯化物116 mg/L.脑电图:异常幼儿脑电图,前头部为主高波幅慢波连续发放,左右不同步,右侧中央区偶见棘慢波发放.经山东省医学影像学研究所颅脑MRI检查表现为:以双额叶为著的脑白质内大片状略长T1长T2异常信号,FLAIR呈高信号,双侧尾状核、豆状核、丘脑、齿状核及脑干见片状略长T2异常信号(图1～6).初步诊断为脑炎.治疗后患儿仍走路不稳.颅脑MRI复查与之前未见明显变化,结合病史及生化检查结果,诊断为亚历山大病.     

多骨型骨纤维异常增殖症核素骨显像误诊为Paget病1例

患者 男,24岁.3周前打篮球后出现左髋疼痛,伴烧灼感,后在活动时出现,静止时疼痛消失,1周前疼痛加重.左髋部未及肿物,皮温不高,无压痛、叩击痛、轴向叩击痛,运动无受限,4字征(-),查癌胚抗原(-).     

跟骨Brodie''''s脓肿误诊为结核性骨脓肿1例

患者,女,51岁。左足跟骨疼痛数年,加重1个月。一般情况尚可,无明显消瘦。自述20a前有踝关节结核手术史。体检:左足皮肤色泽正常,无红肿破溃征象。足跟底部有明显压痛。实验室检查:WBC:5.78×109/L,N:38.8%,L:51.7%;血沉36mm/h。X线检查:左跟骨呈巨大不规则骨质缺损区,边界整齐有薄层硬化,跟骨边缘骨质结构完整。CT扫描5mm层厚,5mm间隔示:左跟骨呈巨大多房状骨质破坏,边缘整齐,有薄层硬化环,破坏区内密度均匀(见图1、图2)。CT值9HU。破坏区外侧缘未见骨膜反应,骨质周围软组织结构层次清楚。CT诊断:跟骨结核;跟骨囊肿。手术:切开皮肤筋…     

Cavernous hemangioma of the cavernous sinus misdiagnosed as a meningioma: a case report and MR imaging findings

Cavernous hemangioma (CH) is a benign vascular malformation. Intracranial CH is generally localized as an intracranial–intraaxial and responsible for 5–13% of all intracranial vascular malformations. Intracranial–extraaxial CHs are rare rather than intracranial–intraaxial CHs. Clinical findings, imaging characteristics, and surgical approach of extraaxial CHs are rather different than intraaxial CHs. Diagnosing cavernous sinus CH preoperatively is very important, but its radiological differential diagnosis is quite difficult. In this study, we present magnetic resonance imaging findings of a 48-year-old male who was considered preoperatively to have meningioma but was diagnosed with cavernous sinus CH during surgery by pathological examination.     

Acalculous inflammatory disease of the biliary tree in acquired immunodeficiency syndrome: CT demonstration

Acalculous inflammatory disease of the biliary tree is a recently recognized complication of acquired immunodeficiency syndrome (AIDS). Two men with AIDS and elevated serum alkaline phosphatase levels are reported. Computed tomography and cholangiography demonstrated biliary disease resembling sclerosing cholangitis.     

Early-stage rheumatoid arthritis: prospective study of the effectiveness of MR imaging for diagnosis

PURPOSE: To assess the effectiveness of magnetic resonance (MR) imaging for the diagnosis of early-stage rheumatoid arthritis (RA). MATERIALS AND METHODS: Fifty subjects (nine men and 41 women) with polyarthralgia who were suspected of having early-stage RA on the basis of clinical and radiographic findings were selected to undergo gadolinium-enhanced MR imaging of the hands. The MR imaging criterion for the diagnosis of early RA was bilateral enhancement in both wrists and/or the metacarpophalangeal and/or proximal interphalangeal joints. Follow-up continued until a final diagnosis was determined. Two patients left the study before the end of follow-up. RESULTS: Final diagnoses were established after a mean follow-up of 776 days: rheumatoid arthritis in 26 patients and nonrheumatoid disease in 22. Use of the MR imaging criterion yielded the correct diagnosis in 25 patients with RA and three false-positive results in three patients without RA. As compared with the traditional format and classification tree criteria of the American Rheumatism Association, the MR imaging criterion allowed detection of seven and six additional patients with true RA, respectively. CONCLUSION: The introduction of MR imaging into the diagnostic criteria for early RA may contribute to more accurate diagnosis in patients suspected of having RA and thus allow an earlier decision to start proper medication.     

超声诊断眼眶纤维型脑膜瘤1例

患者，男性，23岁，左眼眼球突出伴视方下降1个月。全身一般情况好，视力：右眼1.0，左眼0.02，右眼未见异常。左眼球突出度16mm，眼睑无外观畸形，球结膜充血（＋），角膜透亮，前房深度正常，瞳孔圆，直径约3mm,直接与间接对光反应灵敏，晶状体透明，     

Abdominal pain from ingested bone misdiagnosed as appendicitis: Report of a rare case and literature review

Bones are potential foreign bodies that could be accidentally ingested, leading to several symptoms varying from asymptomatic to perforation of the gastrointestinal tract. However, these cases are rare but may be misdiagnosed with other common diseases such as appendicitis. We present in this case a 25-year-old male who presented with appendicitis symptoms, after appendectomy the patient had the same complaint, But the colonoscopy demonstrated a meat bone in the terminal ileum and was removed with the same device. Finally, he was discharged from the hospital without complications and after decreasing abdominal pain. According to the literature review, this is one of the rare cases of using colonoscopy to treat bone impaction non-operatively.     

髌骨动脉瘤样骨囊肿1例

患者 男,19岁,因“右膝关节疼痛1年”入院。查体：右膝关节稍肿胀,皮肤无发红及破溃,右髌骨轻压痛,髌骨研磨试验上不能找到前期病变者称为原发性 ABC；如病理上能找到明确前期病变者称为继发性 ABC。骨巨细胞瘤为最常见的前期病变,软骨母细胞瘤、骨母细胞瘤、骨肉瘤、软骨黏液样纤维瘤及纤维结构不良等亦较为常见。本例在病理上未找到前期病变,即为原发性 ABC。     

左上臂猫抓病性淋巴结炎1例

男,40岁,无意中发现左上臂包块4 d,自诉渐增大.至当地医院彩超检查:于左肘肱动脉后方探及一4.3 cm×1.9 cm×3.5 cm较强光团,形态不规则,边界不清,灶内见2.3 cm×1.0 cm无回声区,提示左上臂囊实性包块,性质待查.为求进一步治疗来本院就诊,以左上臂占位收住入院.患者精神好,食欲可,起病来无发热寒战、头痛头晕、恶心呕吐,无咳嗽咳痰及夜间盗汗,大小便正常.