新生儿早发型先天性骨梅毒的X线诊断

Skeletal Radiographic Findings in Neonates with Early Congenital Syphilis

目的:探讨新生儿先天性梅毒(CS)骨损害的X线表现。方法:收集经临床及实验室检查证实的39例早发型先天性梅毒患儿,回顾性分析其骨骼X线表现。结果:39例CS患儿中有25例(占64.10%)出现不同程度骨损害,主要表现为广泛、多发、对称的骨软骨炎、骨膜炎、骨髓炎等,其中长骨干骺端的骨软骨炎为先天性骨梅毒最早及最具特征性的征象。结论:长骨摄片应作为评估新生儿先天性骨梅毒的一种重要手段,对于梅毒快速血浆反应素试验或梅毒螺旋体血凝测定阳性的婴儿常规进行四肢长骨的X线检查,可以早期发现新生儿先天性梅毒骨损害及其受累程度,有助于临床进行及时治疗。

Purpose：To study the value of skeletal radiographs in diagnosing congenital syphilis（CS）.Methods： Thirty-nine cases of proven congenital syphilis were enrolled in this study,and the skeletal abnormalities were analyzed on the basis of clinical tests.Results：Extensive,multiple,and symmetric bone radiographic abnormalities were identified in twenty-five cases（64.10%）,such as gristle osteitis,periostitis,osteomyelitis,among which metaphysitis was the earliest specific finding of congenital syphilis.Conclusion：The long-bone radiographic examination should be considered in the routine evaluation of infants with positive RPR or TPHA,it is useful for the disease to be detected,diagnosed and treated earlier.