部骨质性骨瘤:一个公认的实体,倾向于误诊
Doris E Wenger1,2, Meagan E Tibbo3, Matthew L Hadley3
1Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA. wenger.doris@mayo.edu.
European radiology
|June 7, 2023
概括
诊断关节骨质性骨质瘤 (OO) 很困难,往往导致误诊和延迟治疗. 识别特征性成像研究结果对于准确及时诊断部疼痛的原因至关重要.
科学领域:
- 整形外科手术 整形外科手术
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
背景情况:
- 部骨质性骨瘤 (OO) 存在诊断上的挑战,因为其症状与常见的部病理重叠.
- 延迟诊断OO可能会导致长时间的疼痛和不适当的治疗.
- 精确的区分从诸如股骨支骨撞击 (FAI) 和应力骨折等条件是必不可少的.
研究的目的:
- 为了确定常见的错误诊断和治疗关节骨骨质瘤.
- 为了确定部OO的诊断延迟的平均时间.
- 突出部OOO的特征性成像特征和诊断陷.
主要方法:
- 对33名患有关节骨骨质瘤的患者 (34种瘤) 进行了回顾性审查,这些患者接受了射频废除治疗 (1998-2020年).
- 影像研究的分析,包括放射 (n=29),CT扫描 (n=34) 和MRI扫描 (n=26).
- 评估最初的错误诊断和最终诊断的时间.
主要成果:
- 最常见的初始错误诊断包括大腿部应力骨折 (n=8),FAI (n=7),恶性瘤/感染 (n=4).
- 从症状发作到OO诊断的平均延迟时间为15个月.
- 从最初的错误诊断到正确的OO诊断的平均延迟是9个月.
结论:
- 很大一部分 (高达70%) 的关节骨骨质瘤最初被误诊.
- 在对部疼痛的差异诊断中,特别是在青少年中,对OO的认识至关重要.
- 熟悉MRI和CT成像特征对于及时和准确的诊断至关重要.
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