家族性骨斑点症2例

骨斑点症又称脆弱性骨硬化或斑点骨 ,属于无症状性骨硬化性发育异常。国内报告较少 ,我院遇到家族发病２例 ,报告如下。病例例１ ,男 ,３２岁 ,因局部外伤后疼痛来我院就诊。Ｘ线表现 :双手各指骨骨端处、掌骨骨端、腕骨 ,双尺桡骨远端、肘关节各骨端附近 ,双肱骨头、肩胛骨 ,双侧股骨头、坐骨、耻骨、髂骨、双膝关节、踝关节各组成骨 ,双足跖骨、趾骨、跗骨 ,颈椎骨髓腔内均有分布不均 ,大小不等、圆形或椭圆形致密斑点状骨硬化灶 ,密度与骨皮质相似 ,较均匀一致 ,有的病灶相互重叠 ,位于长骨的结节灶的长径与骨小梁平行 ,病灶不累及骨皮质…     

家族性骨斑点症2例

骨斑点症于1915年由Albers-shonberg首次报道。本病少见，病因不明，可有家族史。可见于任何年龄，男多于女，本文报道兄弟二人同患此症。     

典型骨斑点症1例

病例女,36岁,外伤后双膝关节疼痛伴轻度活动受限1周.查体：双膝关节压痛阳性,屈曲轻度受限,全身无其它不适.行双膝关节X线平片示：双膝关节干骺端多发斑点状致密影,大小不等,部分融合成斑片状,随后建议患者行拿身照相,片示：全身多个关节干骺端呈对称性斑点状致密影,颅骨平片未见异常.诊断：骨斑点症（图1～5）.     

骨斑点症X线表现2例报道

病例 例1,男,49岁,既往健康,因肩部外伤后疼痛而就诊,摄右肩正位片,显示右肱骨近端髓腔内多发斑点状及索条状高密度影,边界清楚、锐利,周围骨皮质无破坏.后经患者同意,拍摄双侧髋关节、双侧肩关节、双侧腕关节,均显示同样的X线表现.     

1家4代13例骨斑点症

目的：旨在提高对家族性骨斑点症的影像学诊断。方法：先症者为偶然发现,对先症者及其家族进行手X线片检查。结果：共发现13人患骨斑点症,斑点骨好发于手足的掌、指、跖、趾骨、腕、肘、肩、踝、膝、髋关节、骨盆及长骨的干骺端,以手足短骨、腕、踝、骨盆、膝关节最多见,斑点骨大小不一,形态不一,分布不均。表现奇特。结论：斑点骨对人体无害,儿童可随年龄的增长而增多,没发现斑点骨缩小、变少的病例。对先症者观察了37年,为国内观察最长的1例。     

Coexistence of osteopoikilosis with seronegative spondyloarthritis and spinal stenosis

[Purpose] Osteopoikilosis is a rare hereditary bone disease that is usually asymptomatic. It is generally diagnosed incidentally on plain radiography. The coexistence of osteopoikilosis with seronegative spondyloarthritis or spinal stenosis is rarely reported. Here, we report the case of a 27-year-old male patient with osteopoikilosis, seronegative spondyloarthritis, and spinal stenosis. [Subject] A 27-year-old male patient with buttock pain and back pain radiating to the legs. [Methods] A plain anteroposterior radiograph of the pelvis revealed numerous round and oval sclerotic bone areas of varying size. Investigation of the knee joints showed similar findings, and the patient was diagnosed with osteopoikilosis. Lumbar magnetic resonance images showed spinal stenosis and degenerative changes in his lumbar facet joints. Magnetic resonance images of the sacroiliac joints showed bilateral involvement with narrowing of both sacroiliac joints, nodular multiple sclerotic foci, and contrast enhancement in both joint spaces and periarticular areas. HLA B-27 test was negative. [Results] The patient was diagnosed with osteopoikilosis, seronegative spondyloarthritis, and spinal stenosis. Treatment included asemetasin twice daily and exercise therapy. [Conclusion] Symptomatic patients with osteopoikilosis should be investigated for other possible coexisting medical conditions; this will shorten the times to diagnosis and treatment.Key words: Osteopoikilosis, Spinal stenosis, Spondyloarthritis     

Problem of chronic hepatitis (classification, pathogenesis and treatment]

Update information is added to classification of chronic hepatitis. A new form--chronic lobular hepatitis is described as well as characteristic features of immune response to hepatitis B virus (HBV). The findings enable the authors not only to relate autoimmune abnormalities to HBV infection, but to consider them an essential component of this infection. The leading role in pathogenesis of viral hepatic lesions is played by cellular immunity. A sound subpopulation analysis of immunocompetent blood cells was carried out for chronic active hepatitis and hepatic cirrhosis in correlation with HBsAg. It is emphasized that a biological cycle of HBV development determines the type and power of the macroorganism immune response and should be allowed for when designing policy of treatment of chronic hepatic viral diseases. Criteria are proposed for deciding on immunomodulators and immunodepressants for chronic viral and autoimmune hepatitis.