骨质疏松性椎体压缩性骨折的误诊分析

目的探讨骨质疏松性椎体压缩性骨折误诊原因及防范措施。方法回顾性分析212例椎体压缩性骨折患者的病史,记录患者的主要临床症状、体征,以MRI检查结果为诊断标准计算X线、CT检查的阳性率。结果49例无明确外伤史,182例患者以活动时腰背痛为主要表现,172例伴有腹部不适、52例合并胸痛,188例患者查体有伤椎局部叩击痛。X线及三维CT检查阳性率分别是50.9%和82.5%,首诊误诊率29.7%,误诊疾病包括:筋膜炎、腰椎退行性疾病、软组织损伤、腹部疾病、肋间神经痛等。结论骨质疏松性椎体压缩性骨折易于误诊和漏诊,详细分析病史、临床表现结合影像学检查特别是MRI压脂像十分必要。

Analysis of the Misdiagnosis Causes of Osteoprosis Vertebral Compression Fracture

Objective To explore misdiagnosis causes and preventive measures of osteoprosis vertebral compression fracture(OVCF).Methods Clinical data of 212 patients with OVCF were retrospectively analyzed.The clinical symptoms and signs were recorded.The positive rates of X-ray film and three-dimensional CT were caculated respectively according to the results of MRI.Results 49 cases did not have definite injury history.182 paitients had Low back pain during exercise.172 patients had abdominal discomfort,52 patients had chest pain.Percussion pain on spinous were be detected among 188 patients.The positive rates of X-ray film and threedimensional CT were respectively 50.9%and 82.5%.The misdiagnosis rate of the first visit was 29.7%.The main diseases misdiagnosed included fasciitis,spinal degenerative diseases,soft tissue injury,abdominal lesions,intercostal neuralgia et al.Conclusion The rate of miseddiagnosis on the OVCF is high.Meticulous review of the history and clinical manifestation in addition to supplemental imageological examination,espically fat suppression MRI,are essential to diagnosis of osteoprosis vertebral compression fracture.