右足跗骨结核1例

患者男,80岁,主因"右侧足面持续肿胀2年外侧窦道形成"入院.查体:右足背软组织肿胀,远行时疼痛加剧,经窭道分泌腥臭黄白色脓性物.右踝关节正侧位X线摄片:右足第2～5跖骨基底部、楔骨、舟骨、距骨及骰骨和部分跟骨骨质破坏,骨关节间隙显示不清,足背软组织层次混浊、肿胀;右踝后方血管壁钙化,跟骨骨刺生成,跟腱韧带见条形钙化(图1).X线诊断:①右跗骨感染性病变;②右侧跟骨下棘骨质增生;③右侧腓动脉末端及跟腱韧带钙化.CT:右足广泛骨质稀疏,舟骨、骰骨、楔骨及邻近跟骨、距骨、跖骨基底部骨质广泛破坏,部分碎骨片外移;右侧附骨间关节、距跟舟关节、跗跖关节紊乱,关节间隙不规则变窄,关节面骨质弥漫性虫蚀样破坏;邻近跗跖部周围软组织肿胀,脂肪间隙消失(图2).CT诊断:右跗骨、跖骨及对应关节结核改变.病理诊断:跗骨结核.     

甲状腺原发结核1例

1病历摘要 女，38岁。有发热感3个月，否定有腮腺炎及流感等疾病，1个月前发现颈部肿物，无明显压痛，大小约3．0cm×3．0cm×2．0cm，周边部可见2个小肿物，     

外伤性膝关节结核误诊1例

1病历摘要男,8岁。1个月前,玩耍时被他人用竹棒刺伤右膝部,伤后在当地诊所进行清创缝合。术后右膝关节疼痛、肿胀逐渐加重,活动受限,同时伴不规则发热,无夜间盗汗。来院后查体见一般情况尚可,右膝部红、肿、压痛,皮温高于健侧,浮髌试验( ),右膝关节内下部有一约1.0cm伤口已清创缝合一针,伤口有渗液,右膝活动受限。诊断性穿刺抽出大量黄色黏稠脓液,送检为大量白细胞和脓细胞,胸片及右膝关节平片均未见异常,诊断为右膝外伤性化脓性并节炎。入院后行右膝关节切开探查术,术中放出黄色脓液约80ml,关节内部分滑膜坏死脱落未见异常物残留,放置两根…     

膝关节滑膜结核误诊1例

1　病例报告男 ,4 6岁。因撞伤右膝肿痛 ,活动不利 4 0 d以右膝前交叉韧带损伤收入院。 4 0 d前因车祸伤及右膝 ,当即疼痛 ,活动受限 ,我院诊为右胫骨平台骨折 ,行手法复位石膏外固定。复查石膏去除后 ,发现膝关节肿胀压痛 ,前抽屉试验 (± ) ,疑为前交叉韧带损伤。查体 :右膝肿胀 ,股四头肌萎缩 ,皮温不高 ,髌上囊压痛 ,浮髌实验 (+) ,前抽屉实验 (± )。血常规 WBC8.0× 10 9/ L,RBC3.35× 10 1 2 / L ,Hb12 8g/ L ,ESR18mm / h,肝功生化未见异常 ,否认有结核病史 ,关节腔穿刺抽出暗黄色积液 4 0 ml。于入院第 5天行右膝关交叉韧带…     

亚急性血行播散型肺结核继发腱鞘滑膜结核误诊1例

肺结核是常见病，诊断一般不难，但由于部分肺结核表现复杂性和多样性，易造成误诊误治。现将亚急性血行播散型肺结核继发腱鞘滑膜结核误诊为腱鞘肿瘤1例，分析报道如下。     

肩关节结核2例

1病例报告 例1：男，27岁。左肩不明原因性疼痛，伴局部软组织逐渐消瘦、活动受限4个月余。曾在当地医院拍片检查，被诊断为肩周炎，应用中草药薷洗及按摩等方法治疗，但症状仍不能缓解，且有加重之势而来诊。既往无低热盗汗史，12个月前曾患过胸膜炎，现已治愈。查体：体温、脉搏、呼吸、血压尚正常，全身无明显异常；左肩部三角肌萎缩里“方肩”状，大结节处压痛明显，锁骨上窝及腋部淋巴结稍有肿大并有压痛，左肩关节活动完全受限，局部皮肤颜色，温度及感觉均正常；     

双侧髌骨脱位并左侧髌骨畸形1例报告

患者男 ,8岁半。因双侧髌骨不稳 ,膝关节活动障碍 8年来院就诊。查体 :一般情况可 ,右膝关节轻度外翻畸形。右髌骨内侧结构松弛 ,髌骨大小正常 ,可推向股骨外髁外缘 ,于膝关节屈曲时向外脱出 ,伸直时复位。左膝关节不能完全伸直 ,屈曲挛缩约 30° ,左髌骨固定于左股骨外髁 ,轮廓小 ,可轻微推动 ,左股四头肌萎缩 ,肌力 2级。实验室检查 :各项化验指标均在正常范围。Ｘ线表现 :双膝关节轴位片 ,见右股骨下端外髁部变平 ,右髌骨不在髁间凹内 ,向外侧偏移 ,左侧髌骨未见骨化中心。ＣＴ表现 :双膝关节轴位扫描 ,见右髌骨位于外髁前方 ,其骨化中心…     

尺骨骨干上段结核1例

长管状骨骨干结核在骨关节结核病中发病率很低，且大多数发生在长管状骨干骺端，发生在中上段较为少见。     

髌骨痛风1例

患者，男，45岁。左膝关节疼痛、肿胀多年，通过一般药物治疗好转。去年左膝关节突然发生红肿热痛、功能障碍，经门诊治疗无效，疼痛剧烈，收入住院治疗。查体：T38℃，左膝关节明显肿胀，皮肤不发红，局部压痛，伸弯受限，其他四肢关节正常。实验室检查：血沉升高30mm／h，白细胞总数升高。     

Primary duodenal tuberculosis misdiagnosed as tumor by imaging examination: A case report

BACKGROUNDPrimary duodenal tuberculosis is very rare. Due to a lack of specificity for its presenting symptoms, it is easily misdiagnosed clinically. Review of the few case reports and literature on the topic will help to improve the overall understanding of this disease and aid in differential diagnosis to improve patient outcome.CASE SUMMARYA 71-year-old man with a 30-plus year history of bronchiectasis and bronchitis presented to the Gastroenterology Department of our hospital complaining of intermittent upper abdominal pain. Initial imaging examination revealed a duodenal space-occupying lesion; subsequent upper abdominal contrast-enhanced computed tomography indicated duodenal malignant tumor. Physical and laboratory examinations showed no obvious abnormalities. In order to confirm further the diagnosis, electronic endoscopy was performed and tissue biopsies were taken. Duodenal histopathology showed granuloma and necrosis. In-depth tuberculosis-related examination did not rule out tuberculosis, so we initiated treatment with anti-tuberculosis drugs. At 6 mo after the anti-tuberculosis drug course, there were no signs of new development of primary lesions by upper abdominal computed tomography, and no complications had manifested.CONCLUSIONThis case emphasizes the importance of differential diagnosis for gastrointestinal diseases. Duodenal tuberculosis requires a systematic examination and physician awareness.     

耻骨结核1例

患儿,男,10岁,因会阴部不适疼痛5个月,近日出现低热、盗汗,疼痛加重,口服抗生素无效入院.查体:体温37.5℃,耻骨联合右下方压痛明显,未触及明显包块,双侧腹股沟淋巴结无肿大,骨盆挤压及分离引起会阴部疼痛.实验室检查:血白细胞10.5×109/L,血沉65 mm/L,结核菌素试验强阳性(红色丘疹18 mm).     

乳腺结核超声误诊1例

患者女,30岁.右乳房肿块半年余,疼痛半个月.查体:右乳房明显肿胀,外上象限皮肤略红肿呈桔皮样外观,局部可触及约10 cm×4 cm肿块,质硬,不移动,有轻微触痛,同侧腋窝可触及肿大淋巴结.超声所见:右乳腺结构不良,外上象限与部分内上象限内见一约7 cm×3 cm低回声团块,边界不清,形态不规则,可见小分叶征象,后方回声略衰减.肿块外侧部分呈低回声区,有流动感,且穿透乳腺筋膜至皮下组织(图1).CDFI:血流丰富呈Ⅲ级血流,并可见明显动脉血流,RI 0.68(图2).同侧腋窝见三枚近圆形肿大淋巴结.超声诊断:右乳腺癌,肿瘤液化感染.手术切除右乳腺肿块,术中见肿块与周围组织界限不清,周边血管丰富,可见脓腔并大量干酪样物质.病理诊断:右乳腺结核合并感染.     

先天性双髌骨发育较小伴习惯性脱位1例

患者女,50岁.身高142 cm,自述4岁多才能走路,自幼常因轻微外伤导致膝部疼痛,行走困难,自行按摩后缓解,不能追忆家族中有类似患者.查体:双膝关节肿胀、有压痛,外翻畸形,下蹲困难,身材矮小.X线示:双髌骨明显变小、畸形,骨密度不均,股骨外侧髁发育不良,呈扁平状;关节间隙外宽内窄,髌骨下移且大部位于股骨外髁外侧,髌骨间隙失常;双侧髌骨明显外下移位,股骨髁间凹几近变平,凹面基本消失.     

超声诊断睾丸及附睾结核1例

患者男,49岁.以"右睾丸及附睾肿物"入我院治疗.超声检查:右侧睾丸内可见弥漫性呈点片状低回声团,不规则(图1),睾丸内见有丰富的彩色血流.右侧附睾明显增大,头体部5.0 cm×2.6 cm,尾部3.0 cm×1.6 cm,呈低回声,其内可见有较丰富的彩色血流.右侧睾丸鞘膜内可显示4.9 cm×3.6 cm的液性暗区,有分隔.右腹股沟区可显示多数个低回声团,最大的1.6 cm×0.7 cm.超声诊断:①右侧睾丸内低回声团性质待定,占位性病变待除外;②右侧附睾炎性改变伴鞘膜积液;③右侧腹股沟淋巴结增大.术后病理:右侧睾丸及附睾结核.     

腹腔、腹膜后间隙淋巴结核伴大量乳糜腹1例报告

患者女，20岁，以渐进性腹胀5个月就诊。查体：患者明显消瘦，呈贫血貌，腹部明显膨隆，移动性浊音阳性，无局部压痛反跳痛，无咳嗽、咳痰、胸痛，无发热。     

超声诊断泌尿生殖系统结核1例

患者男．37岁,间歇性右侧附睾肿痛2年余．加重1天．以右附睾结核、右肾结核入院。查体：一般情况尚可。右侧睾丸、附睾肿大,质地硬．表面不光滑．压痛（＋）。左侧正常。前列腺指诊正常。超声检查：左肾及输尿管未见异常。右肾大小106mm×61mm,形态饱满．体积略增大,包膜欠光整,实质变薄．厚度3～7mm,肾盏扩张呈“花瓣样”改变．     

Esophageal tuberculosis complicated with intestinal tuberculosis: A case report

BACKGROUND Although the overall incidence of tuberculosis in underdeveloped areas has increased in recent years, esophageal tuberculosis(ET) is still rare. Intestinal tuberculosis(ITB) is relatively more common, but there are few reports of ET complicated with ITB. We report a case of secondary ET complicated with ITB in a previously healthy patient.CASE SUMMARY A 27-year-old female was hospitalized for progressive dysphagia, retrosternal pain, acid regurgitation, belching, heartburn, and nausea. Upper gastrointestinal endoscopy showed a mid-esophageal ulcerative hyperplastic lesion. Endoscopic ultrasonography showed a homogeneous hypoechoic lesion, with adjacent enlarged lymph nodes. Biopsy histopathology showed inflammatory exudation,exfoliated epithelial cells and interstitial granulation tissue proliferation.Colonoscopy revealed a rat-bite ulcer in the terminal ileum and a superficial ulcer in the ascending colon, near the ileocecal region. The ileum lesion biopsy showed focal granulomas with caseous necrosis. Polymerase chain reaction for Mycobacterium tuberculosis was positive in the esophageal and ileum lesion biopsies. The T-cell spot tuberculosis test was also positive. The patient was diagnosed with secondary ET infiltrated by mediastinal lymphadenopathy and complicated with ITB, possibly from the Mycobacterium tuberculosis-infected esophageal lesion. After 2 mo of anti-tuberculosis therapy, her symptoms improved significantly, and upper gastrointestinal endoscopy showed healing ulcers.CONCLUSION When dysphagia or odynophagia occurs in patients at high-risk for tuberculosis,ET should be considered.