儿童耻骨骨病变的临床表现及影像学特征分析

Clinical manifestations and imaging features of pubic bone lesions in children

目的初步探讨儿童耻骨骨病变的临床表现以及影像学特征,以提高儿童耻骨骨病变的临床诊断水平。方法回顾性分析2009年1月至2020年5月于南京医科大学附属儿童医院骨科经手术及病理检查确诊的10例耻骨骨病变患儿临床资料,收集患儿临床表现、病种分布及影像学特征进行分析。结果10例患儿中男、女各5例;病变累及左、右侧耻骨各5例;年龄4岁4个月至15岁(平均年龄10岁7个月)。初诊时表现为腹股沟疼痛伴跛行8例,腹股沟疼痛伴发热1例,体检摄片发现1例。8例行X线检查,10例行CT检查(其中7例同时行MRI检查)。术后病理结果:朗格汉斯细胞组织细胞增生症4例,纤维结构不良2例,慢性骨髓炎、骨结核、骨软骨瘤及单纯性骨囊肿各1例。结论儿童耻骨骨病变临床少见,病变类型及影像学表现多样;单纯依靠临床表现和影像学检查诊断较为困难,确诊需依赖病理检查,病理上多为良性病变,恶性病变少见;手术治疗通常能获得较好效果。

Objective To explore the disease distribution and imaging features of pubic lesions in children.Methods From January 2009 to May 2020,a total of 10 pathologically confirmed children with pubic bone lesions were retrospectively reviewed.Clinical manifestations,disease distribution and imaging features were analyzed.Results There were 5 boys and 5 girls with an average treatment age of 10.7(4.3-12.58)years.The involved side was left(n=5)and right(n=5).Chief complaints included groin pain&limping(n=8)and groin pain&fever(n=1).The relevant examinations included radiology(n=8),computed tomography(CT,n=10)and magnetic resonance imaging(MRI,n=7).The pathological diagnosis was Langerhans cell histiocytosis(n=4),fibrous dysplasia(n=2),chronic osteomyelitis(n=1),basal tuberculosis(n=1),simple bone cyst(n=1)and osteochondroma(n=1).Conclusion Pubic bone lesions are rare in children.Great varieties of pubic bone lesions exist in children and their imaging features are characteristic.It is rather difficult to make a definite diagnosis solely on the basis of clinical and imaging features and surgery often yield better outcomes.Most lesions are benign and operations have a decent prognosis without any obvious sequel.