肺性肥大性骨关节病的临床及X线诊断

CLINICAL RESEARCH ON CLINICAL AND X-RAY DIAGNOSIS OF PULMONARY HYPERTROPHIC OSTEOARTHROPATHY

目的:探讨肺性肥大性骨关节病的临床及X线表现,以提高对本病的诊断及鉴别诊断的能力。方法:回顾性分析5例肺性肥大性骨关节病病人的临床及X线特征。结果:①骨改变:四肢长管状骨双侧对称性骨膜增生5例;增生的骨膜呈层状3例,葱皮样1例,花边样1例;骨膜新生骨与骨皮质有透亮线者4例;杵状指(趾)5例;骨干增粗3例。②胸部病变:5例中肺癌3例,均为周围型肺癌;慢性支气管炎1例;肺脓肿1例。结论:肺部疾病、杵状指(趾)及双侧管状骨对称性骨性增生等为肺性肥大性骨关节病的典型表现,且不论骨膜增生何等广泛,骨皮质和髓腔多不受累,骨膜新生骨与骨皮质之间多可见一透亮线,掌握以上特点可对本病做出正确诊断。

Objective:To approach the clinical and X-ray manifestations of pulmonary hypertrophic osteoarthropathy(PHOA),and elevate the ability of diagnosis and differential diagnosis on it.Methods:5 cases of patients with PHOA were chosed,and the clinical and X-ray characteristics were retrospectivly analyzed.Results:Some manifestations were seen.① Changes on bone:5 cases had symmetry periosteal proliferation on both sides of extremity long tubular bones,3 cases were lamellar,1 case was onion-skin pattern and the rest was lace pattern.4 cases had lucency lines on newly formed bone of periosteum and cortical bone,5 cases had achropachy,bone dry thickening was 3 cases.②Pathological changes of chest:3 cases had lung cancer and all were peripheral lung cancer,1 case had chronic bronchitis and the rest had pulmonary abscess.Conclusion:Pulmonary disease,achropachy and symmetry periosteal proliferation of both sides of tubular bones were typical manifestations of PHOA,cortical bone and camera pulpi were not affected with expanding of periosteal proliferation.There had lucency line on newly formed bone of periosteum and cortical bone.We could diagnose correctly PHOA according to features above.