进行性骨化性肌炎51例中国文献报道的综合分析

目的进行性骨化性肌炎(myositisossificansprogressiva,MOP)是一种先天性遗传性疾病,临床较罕见,国内多为个案报道,临床资料不系统,文章综合分析了国内51例MOP病例,总结MOP在我国发病的基本情况。方法光盘检索出自1979～2001年共31篇有关MOP文献报道,共51例,综合分析了51例MOP的临床表现、诊断、治疗及预后。结果我国MOP男性较女性患病率稍高,发病时间主要集中在0～5岁,从发病到明确诊断的间隔为7.88年,33例报道有手指、脚趾异常,首发症状多为颈后软组织包块,脊柱最容易受累。在12岁内,可导致身体大关节僵直,造成患者生活能力丧失。我国有关MOP临床治疗资料较少,且缺乏长期随访资料。结论MOP在我国发病多在0～5岁期间。脊柱是最常被侵犯的部位。     

进行性骨化性肌炎51例中国文献报道的综合分析

目的：进行性骨化性肌炎（myositis ossificans progressiva,MOP)是一种先天性遗传性疾病，临床较罕见，国内多为个案报道，临床资料不系统，章综合分析了国内51例MOP病例，总结MOP在我国发病的基本情况。方法：光盘检索出自1979－2001年共31篇有关MOP献报道，共51例，综合分析了51例MOP的临床表现、诊断、治疗及预后。结果：我国MOP男性较女性患病率稍高，发病时间主要集中在0－5岁，从发病到明确诊断的间隔为7．88年，33例报道有手指、脚趾异常，首发症状多为颈后软组织包块，脊柱最容易受累。在12岁内，可导致身体大关节僵直，造成患生活能力丧失。我国有关MOP临床治疗资料较少，且缺乏长期随访资料。结论：MOP在我国发病多在0－5岁期间。脊柱是最常被侵犯的部位。     

高频超声对骨化性肌炎的诊断价值

目的探讨高频超声在骨化性肌炎诊断中的作用。方法总结1999～2006年在我院接受高频超声检查并经手术证实为骨化性肌炎患者19例的超声检查情况。结果骨化性肌炎骨化未成熟期声像图表现为不均匀低回声肿块，骨化成熟后，声像图表现为强回声肿块，后方伴声影。结论高频超声在骨化性肌炎诊断中有重要作用，可为临床提供极有价值的诊断依据，具有广阔的临床应用前景。     

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.     

局限性骨化性肌炎特征探讨

骨化性肌炎是发生于软组织特别是肌肉内的一种瘤样病变,分为两大类,一类为局限性骨化性肌炎,另一类为进行性骨化性肌炎.进行性骨化性肌炎是一种遗传性、进行性结缔组织疾患,是一种全身性的疾患.局限性骨化性肌炎常常由于创伤、手术等很多致病因素引起,少数无明显诱因,该病往往会引起疼痛和功能障碍,根据病因学的研究,有很多预防和治疗方法,局限性骨化性肌炎的治疗应该采用综合的方法.     

超声对局限性骨化性肌炎的诊断价值

目的：探讨超声对局限性骨化性肌炎的声像图特征及其诊断价值。方法：回顾性总结了１４例经手术及病理证实的局限性骨化性肌炎的超声诊断经验,并与病理结果进行对照分析。结果：１４例显示为三种不同类型声像图表现：早期３例显示为局限性低回声较均匀的肿块,无声影;中期３例病灶显示不均匀低回声,肿块内可见散在高回声,周边部并有薄层骨化强回声环,有声影;成熟期８例,肿块显示为不规则多层强回声,并有明显声影。上述各期具有一定特征性,并有各自不同的病理组织学改变。除３例早期病灶边缘回声较清外,余１１例均模糊不清。结论：超声对局限性骨化性肌炎诊断是有用的,在早、中期优于Ｘ线     

局限性骨化性肌炎的超声诊断

局限性骨化性肌炎临床并非罕见,但超声诊断此病仅见少数个案报道。近年来我们用超声诊断局限性骨化性肌炎４例,并为手术和病理所证实。现将其特殊声像图表现报告如下。本文４例中３例为２０～２４岁的青年男性,１例为６５岁的老年女性。均有外伤史,并于外伤后３周～７个月出现局部疼痛性肿块并周围关节活动受限而就诊。其中双侧大腿１例,单侧大腿２例,臀部１例。Ｘ线检查２例未见异常,２例示软组织内钙化性团块。仪器采用ＡＴＬＵＭ９ＤＰ型超声诊断仪,探头频率５ＭＨｚ,于肿块处直接扫查。典型病例例１,男,２０岁。右大腿前方中…     

脊髓损伤后异位骨化的病因学研究

临床上,异位骨化主要有3种形式：①神经源性异位骨化（neurogenic heterotopic ossification,NHO）,继发于严重神经疾患,如脑外伤、脊髓损伤（spinal cord injury,SCI）、中枢神经系统感染等;②创伤后异位骨化,包括骨折、脱位、人工关节置换术后等;③原发性异位骨化,如进行性骨化性肌炎（myositis ossificans progressiva,MOP）或进行性纤维不良性骨化（fibrodysplasia ossificans progressiva,FOP）.     

异位骨化的治疗进展

异位骨化（heterotopic ossification,HO）是指正常情况下非钙化组织发生新骨形成、关节周围软组织中出现成熟板层状骨的现象。多半发生在大关节周围,例如髋关节,肘关节。包括继发于肌肉、骨骼损伤后的异位骨化,创伤后神经源性异位骨化以及原发性进行性骨化性肌炎等。近年来随人工髋关节的广泛应用及人工髋臼骨折切开复位内固定的推广,异位骨化的发生率显著提高,日益受到骨科界的关注。     

抗γ-氨基丁酸B受体脑炎的临床与影像学特点

目的  探讨抗γ-氨基丁酸B（GABA-B）受体脑炎患者的临床表现、实验室检查及影像学特点。方法  选取我院2021年5月~2022年11月临床资料完整、符合《中国自身免疫性脑炎诊治专家共识（2022年版）》中自身免疫性边缘性脑炎的诊断标准,并经免疫学检查确诊为抗GABA-B受体脑炎的患者3例,收集其临床表现、脑脊液检查、免疫学检查、脑电图、影像学检查等资料进行回顾性分析。结果  3例患者均急性起病,以癫痫发作为首发症状或主要临床表现,伴不同程度的认知功能障碍及精神行为异常。3例患者发病时均合并肿瘤,分别为多发性骨髓瘤、肺癌及鼻咽癌。脑脊液及血清免疫学提示脑脊液和（或）抗GABA-B受体抗体阳性。脑电图均异常,呈癫痫样放电、散在分布或弥漫性慢波。影像学检查见病灶累及单侧海马,头颅CT呈低密度影,头颅MRI呈长T1、长T2信号,T2 FLAIR高信号,DWI高信号,ADC呈等或稍高信号。结论  抗GABA-B受体脑炎患者以癫痫发作为主要表现,易合并肿瘤。抗GABA-B受体脑炎合并鼻咽癌为首次报道,扩展了疾病谱。     

Temporomandibular joint ankylosis—“Knowing when not to operate”: Case report and qualitative systematic review of literature

Temporomandibular joint ankyloses (TMJA) may manifest in patients with several predisposing systemic conditions. A case of extraarticular TMJA is presented in a patient diagnosed with fibrodysplasia ossificans progressive (FOP) is presented. The features, diagnosis, and management of TMJA superimposed on this condition are presented through a qualitative systematic review of literature.     

特殊类型骨化性肌炎影像诊断(附3例报告)

本文报告了3例特殊类型骨化性肌炎X线及CT表现；临床、病理学特点；讨论了影像诊断要点。分型及鉴别诊断。     

Giant nontraumatic myositis ossificans in a child: A case report

BACKGROUNDNontraumatic myositis ossificans is a rare disease whose specific pathogenesis is unclear. Early diagnosis of this disease is very difficult in children because of difficulties in determining medical history and nonspecific early clinical manifestations, which may lead to the failure of timely and effective diagnosis and treatment in some patients. We report the diagnosis and treatment of a child with nontraumatic myositis ossificans and summarize the clinical characteristics and diagnosis and treatment of the disease.CASE SUMMARYAn 8-year-old girl first came to our hospital for more than a week with pain in the right lower limb. There was no history of trauma or strenuous activities. On physical examination, no mass on the right thigh was found, and the movement of the right lower extremity was limited. Ultrasonography showed synovitis of the hip, and bed rest was recommended. Three days later, the child’s pain persisted and worsened, accompanied by fever and other discomforts. She came to our hospital again and a mass was found on the right thigh with redness and swelling on the surface. The images showed a soft tissue tumor on the right thigh with calcification. Routine blood tests revealed that the inflammation index was significantly increased. In case of infection, the patient was given antibiotics, and the pain was relieved soon after, without fever. However, the right thigh mass persisted and hardened. The patient underwent incision biopsy more than 1 mo later, and the postoperative pathology showed nontraumatic myositis ossificans. After approximately 9 mo of observation, the tumor still persisted, which affected the life of the child, and then resection was performed. Since follow-up, there has been no recurrence.CONCLUSIONDue to the difficulty in discerning a child''s medical history and the diverse early manifestations, it is difficult to diagnose nonossifying muscle disease in children in its early stage. Measures such as timely follow-up and periodic image monitoring are conducive to early diagnosis of the disease. The disease has a certain degree of self-limitation, and it can be observed and treated first. If the tumor persists in the later stage or affects functioning, then surgery is considered.     

血浆置换治疗5例海洛因海绵状白质脑病的临床分析

目的分析海洛因海绵状白质脑病（HSLE）的临床特点和诊断治疗情况。方法对5例HSLE患者的临床症状、影像学及血浆置换治疗进行分析。结果3例临床症状改善,1例无变化,1例死亡。结论HSLE患者均有海洛因吸食或静脉注射史,临床主要表现一系列神经系统症状,影像学显示受累部位多位于双侧小脑半球,脑干桥脑、中脑,丘脑、内囊后肢,额颞叶,枕顶叶,皮层下白质和脑室周围白质,胼胝体压部、血浆置换(PE)可能有效。     

标准化尘螨疫苗免疫治疗过敏性鼻炎的疗效

目的探讨过敏性鼻炎患者进行标准化尘螨变应原疫苗免疫治疗时,护理干预、强化心理护理和健康教育对免疫治疗进度及治疗效果的影响。 方法将86例过敏性鼻炎患者进行标准化尘螨变应原疫苗（安脱达）免疫治疗,治疗基础上实行护理干预、强化心理护理和健康教育,并对治疗疗效和症状改善评分, 全身不良事件分级。 结果86例患者全部完成2年的免疫治疗,无脱漏病例。治疗结束时显效38例（44.2%）、有效42例（48.8%）、无效6例（7%）,总有效率为93%。 结论安脱达免疫治疗过敏性鼻炎疗效是安全、有效、可靠的,高质量的护理干预是确保治疗效果的关键。      

Fibrodysplasia (myositis) ossificans progressiva: clinicopathological features and natural history

Patients with fibrodysplasia (myositis) ossificans progressiva (FOP) (<it>n</it> = 28) were studied for up to 24 years. All had characteristic short big toes potentially recognizable at birth; there were radiographic changes in the toes, thumbs, cervical spine and metaphyses of the long bones, including exostoses. Ossification in the large skeletal muscles began from birth to 16 years (mean age 4.6 years) initially in 25 patients in the neck and upper spinal muscles, and later around the hips, major joints and jaw. The rate and extent of disability was unrelated to the time of onset. There was no evidence that any form of treatment produced consistent benefit. Despite the unique combination of skeletal abnormalities and ectopic ossification, the first diagnosis in patients with FOP was often wrong and usually delayed after ectopic ossification began (mean 2.7 years, range 0-14). Except where presentation was unusual, such as progressive stiffness, this delay was mainly due to failure to recognize the significance of the abnormal toes. The most frequent erroneous histological diagnoses were soft tissue sarcoma or fibromatosis. This series emphasizes the usually incorrect initial diagnosis, the misinterpretation of the histology, the unpredictable prognosis and the failure of current treatment. Despite its extreme rarity, there is a need for wider knowledge of this condition both to avoid clinical errors and to stimulate research.      

小儿外伤性骨化性肌炎的超声诊断

目的探讨小儿外伤性骨化性肌炎（PTMO）早期和成熟期的超声影像表现及其临床意义。 方法选择2014年1月至2016年5月在深圳市儿童医院确诊的7例PTMO患儿,对其临床、病理检查结果及超声表现进行分析。 结果7例患儿中5例超声检查后经手术切除获得了病理诊断（2例为早期、3例为成熟期）;2例经超声和MRI或CT影像检查确诊。2例早期PTMO超声表现为外伤局部的肌间低回声,边界清,内部显示纤细高回声,未显示明显钙化;能量多普勒显示枝条状血流信号。5例成熟期PTMO超声表现为低回声团块,内部显示条带状钙化,伴后方声影;彩色多普勒血流成像局部呈稀疏点状血流信号。 结论超声检查可根据肿块的声像图表现,早期识别小儿PTMO,为临床诊断和治疗提供有用的信息。