新生儿先天性梅毒骨骼改变的X线表现

目的:探讨新生儿先天性梅毒骨骼X线表现的诊断及其治疗后随访的价值.方法:搜集经临床及梅毒血清学检查确诊的新生儿先天性梅毒的X线平片资料进行回顾性分析.结果:232例中149例长骨有异常改变,长骨干骺端先期钙化带下透亮带55例,干骺端不光整、呈锯齿状改变34例,干骺端见尖角征31例,骨干密度不均9例,骨干骨皮质增厚2例,骨膜反应11例.不规则骨改变6例,短骨改变10例,表现为髂骨先期钙化带下见弧形透亮带3例,肩胛骨先期钙化带下见弧形透亮带3例,掌骨周围见透亮带4例,跟骨周围见环形透亮带3例,距骨见环形透亮带3例.24例随访病人,6～12个月骨骼破坏基本修复.结论:新生儿先天性梅毒骨骼受累出现率较高,其X线表现具有一定的特征性,可作为一种诊断手段,并指导治疗和评价疗效.

Radiographic Findings of Skeletal Lesions in Congenital Syphilis in Newborn

Objective:To evaluate the value of skeletal radiography in the diagnosis of congenital syphilis in newborns as well as the follow-up after treatment.Methods:The skeletal radiographic manifestations of 232 newborn patients with congenital syphilis were analyzed retrospectively.Results:Long bone abnormalities were indentified in 149 of 232 cases.There were lucent band under provisional calcification zone of long bone metaphysis (n=55),irregular metaphysis with serrated appearance (n=34),metaphyseal spiculation (n=31),heterogeneous density of diaphysis (n=9) and periosteal reaction (n=11).In addition.abnorrmalities were found in irregular bones in 6 cases and in short bones in 10 cases.There were lucent bands at the edge of ilium (n=3),scapular bone (n=3),metacarpal bone (n=4),calcaneus (n=3) and talus (n=3).Repair of the skeletal abnormalities were revealed during 6~12 months follow-up after treatment.Conclusion:High incidence of skeletal abnormalities can be assessed in newborn with congenital syphilis,the characteristic radiographic manifestations are very helpful for the diagnosis,treatment planning and therapeutic evaluation.