踝关节结核的X线及CT诊断(附5例分析)

X-ray and CT manifestation of tuberculosis of ankle joint:an analysis of 5 cases

[目的]探讨踝关节结核的平片、CT诊断及鉴别诊断。[方法]搜集5例经手术、病理证实的踝关节结核,并对其CT、平片表现及鉴别进行了分析。[结果]5例均为右侧全关节结核。典型影像学表现:(1)关节面模糊、糜烂,虫蚀样骨质破坏,松质骨内破坏区呈"穿凿样",内有小死骨;(2)关节间隙狭窄或不规则增宽;(3)病变区及周围骨质疏松;(4)胫、腓骨远端广泛骨膜反应;(5)冷脓肿和窦道形成。[结论]踝关节结核的CT、X线表现有一定的特点,CT优于X线检查。早期正确诊断的关键在于提高对本病的警惕性。

[ Objective] To investigate X-ray and CT manifestations of tobereulosis of ankle joint and to discuss the differentiation with other diseases. [ Method] The X-ray and CT findings in 5 cases with pathalogically proved tuberculosis of ankle joint were retrospectively analyzed. The differentiation with other diseases was discussed. [ Result] The lesions involved entire right ankle joint in all 5 cases, The typical signs were as follows： （ 1 ） indistinct and erosive joint surface, insect bitten-like of bony destruction ofjotht surface, digging-like shape of cancellous bone＇s destruction; （2） narrowed or irregular widened joint space; （3） ostooporosis of diseased region and surrounding; （4） extensive periostoal reaction of distal tibia and fibula; （5） to form cold abscess and sinus tract. [ Conclusion] The tuberculosis of ankle joint earyies certain characteristic X-ray and CT signs, CT is better than X-ray in diagnosis. Highly alert of ankle joint tuberculosis is the key of early correct diagnosis.