坐骨耻骨结合处骨软骨病(Van Neck病)临床及影像学表现并文献回顾

目的 结合文献回顾观察坐骨耻骨结合处骨软骨病Van Neck病(VND)]临床及影像学表现。方法 纳入12例VND患儿,回顾相关文献选出另12例资料完整的VND患儿,综合分析其临床特点及影像学征象。结果 24例VND中,男21例、女3例,年龄4～14岁;均为单侧病变,左侧16例、右侧8例;其中10例诉患侧腹股沟区疼痛,8例患侧髋关节疼痛,5例臀部疼痛,1例患侧下肢痛伴活动受限。X线片和平扫CT见患侧坐骨耻骨结合处局限性膨隆,其内骨质密度不均并可见低密度区,病灶边缘不规则伴硬化;MRI均见患侧坐骨耻骨结合处呈T1WI低信号、T2WI和T2脂肪抑制序列高信号(17/17,100%),10例(10/17,58.82%)坐骨耻骨结合处梭形肿胀,7例(7/17,41.18%)病灶边缘不规则,10例(10/17,58.82%)周围软组织水肿,8例(8/17,47.06%)可见“纤维桥接”表现。结论 VND见于儿童,临床表现为单侧腹股沟区疼痛、髋关节疼痛或臀区疼痛;MRI均见坐骨耻骨结合处信号改变,近半数边缘不规则、可见“纤维桥接”,半数以上局部可见梭形肿胀及邻近软组织信号改变。X线和CT平扫可用...

Clinical and imaging features of osteochondrosis of ischio-pubic synchondrosis (Van Neck disease) and literature review

Objective To observe the clinical and imaging features of osteochondrosis of ischio-pubic synchondrosis (Van Neck disease ). Methods Twelve VND children were enrolled. Another 12 VND children with complete data were screened out from relative literature, and the clinical and imaging characteristics of all above 24 cases of VND were comprehensively analyzed. Results Among 24 VND children, there were 21 boys and 3 girls, aged from 4 to 14 years, all with unilateral lesion, including left side lesion in 16 cases and right side lesions in 8 cases. The main complains included inguinal pain in 10 cases and hip pain in 8 cases on the affected side, 5 cases of buttock pain and 1 case of lower limb pain with limited movement. X-ray film and plain CT showed localized swelling at the ischiopubic junction on the affected side, with uneven internal bone density, low density area, irregular edge and edge sclerosis. MRI showed low signal intensity on T1WI and high signal intensity on T2WI and T2 fat-suppression sequences at the ischiopubic junction on the affected side in all 17 cases. Fusiform swelling at the ischiopubic junction was found in 10 cases (10/17,58.82%), irregular margin was noticed in 7 cases (7/17,41.18%), while surrounding soft tissue edema was observed in 10 cases (10/17, 58.82%) and "fibrous bridging" was detected in 8 cases (8/17, 47.06%). Conclusion VND occurred in children, most present as unilateral lesion, with inguinal pain, hip pain or buttock pain on the affected side. MRI showed signal changes at the ischiopubic junction, nearly half lesions with irregular margin and "fibrous bridging", more than half lesions with local fusiform swelling and signal changes of adjacent soft tissue. X-ray and plain CT scanning could be used for initial screening of VND.