新生儿先天性梅毒骨骼改变的X线表现

Radiographic Findings of Skeletal Lesions in Congenital Syphilis in Newborn

目的：探讨新生儿先天性梅毒骨骼X线表现的诊断及其治疗后随访的价值。方法：搜集经临床及梅毒血清学检查确诊的新生儿先天性梅毒的X线平片资料进行回顾性分析。结果：232例中149例长骨有异常改变，长骨干骺端先期钙化带下透亮带55例，干骺端不光整、呈锯齿状改变34例，干骺端见尖角征31例，骨干密度不均9例，骨干骨皮质增厚2例，骨膜反应11例。不规则骨改变6例，短骨改变10例，表现为髂骨先期钙化带下见弧形透亮带3例，肩胛骨先期钙化带下见弧形透亮带3例，掌骨周围见透亮带4例，跟骨周围见环形透亮带3例，距骨见环形透亮带3例。24例随访病人，6～12个月骨骼破坏基本修复。结论：新生儿先天性梅毒骨骼受累出现率较高，其X线表现具有一定的特征性，可作为一种诊断手段，并指导治疗和评价疗效。

Objective：To evaluate the value of skeletal radiography in the diagnosis of congenital syphilis in newborns as well as the follow-up after treatment. Methods： The skeletal radiographic manifestations of 232 newborn patients with congenital syphilis were analyzed retrospectively. Results： Long bone abnormalities were indentified in 149 of 232 cases. There were lucent band under provisional calcification zone of long bone metaphysis （n= 55） ,irregular metaphysis with serrated appearance （n= 34）, metaphyseal spieulation （ n= 31 ）, heterogeneous density of diaphysis （n= 9 ） and periosteal reaction （n= 11）. In addition, abnorrmalities were found in irregular bones in 6 cases and in short bones in 10 cases. There were lucent bands at the edge of ilium （n=3） ,scapular bone （n=3） ,metacarpal bone （n=4） ,ealeaneus （n=3） and talus （n= 3）. Repair of the skeletal abnormalities were revealed during 6 - 12 months follow-up after treatment. Conclusion=High incidence of skeletal abnormalities can be assessed in newborn with congenital syphilis, the characteristic radiographic manifestations are very helpful for the diagnosis, treatment planning and therapeutic evaluation.