小儿急性化脓性股骨颈骨髓炎的早期诊断

The Early Diagnosis of Acute Suppurative Osteomyelitis of Femoral Neck in Children

为了研讨小儿急性化脓性股骨颈骨髓炎的早期诊断和与化脓性髋关节炎的鉴别诊断,通过28例小儿急性化脓性股骨颈骨髓炎的临床观察和核医学等检查,以及手术中发现,小儿急性化脓性股骨颈骨髓炎早期除髋关节前后压痛外,股骨大粗隆附近亦有肿胀和压痛,髋关节腔穿刺液体为稀薄的渗出液体。同位素股骨颈扫描,可见患侧同位素吸收增多。因此,经过仔细的临床检查和同位素检查,可以早期作出诊断。对诊断困难,临床高度怀疑的病例应行手术探查,以达到早期诊断和早期治疗。

Objective:To discuss early diagnosis of acute suppurative osteomyelitis of the femoral neck and the differential diagnosis from acute pyogenie arthritis of the hip.Method:28 children with acute femoral suppurative osteomyelitis were studied basing on the clinical presenta- tion,isotopic bone scan and exploration findings.Results:Swelling and tenderness were found in the greater trochanter region in addition to the regions anterior and posterior to the hip,and thin seepage was obtained by arthrocentesis.The uptake of radioisotope was concentrated in affected femoral neck.Conclusion:Early diagnosis of acute suppurative osteomyelitis of the femoral neck can be made by careful clinical examination and isotopic bone scan.Surgical exploration should be performed on difficult cases to achieve an early diagnosis and treatment.