先天性早发型骨梅毒的影像学诊断意义

Significance of Imaging Diagnosis for Early Congenital Syphilis

目的:探讨早发型先天性骨梅毒的临床特点及影像学表现。方法:回顾性总结我院2008年1月～2012年3月资料较完整的早发型先天性骨梅毒12例,且全部经血清学诊断并摄四肢长骨线片,分析其影像学特点。结果:12例中均有骨骼异常改变。干骺端炎12例,其中6例可见Wimberger征,2例病理性骨折,骨髓炎8例,骨膜炎10例,软组织肿胀12例,其它如颅骨、脊柱、髂骨未见明显异常改变。广泛、多骨、对称性的干骺端炎、骨膜炎、骨髓炎为骨梅毒的X线特征。结论:早发型先天性骨梅毒有一定的特征性,且骨损坏特别是干骺端损害常表现在其他临床症状出现之前,我们认为凡是怀疑有先天性骨梅毒的患儿均应常规作四肢长骨摄片检查,为临床早期诊断、早期治疗及后续疗效观察提供参考。

Objective：To investigate the clinical features and imaging manifestations of the early congenital syphilis of bone. Methods： Retrospectively 12 cases of early bone congenital syphilis, which information was more complete, in our hospital from January 2008 to March 2012. They were diagnosed by serology and long bone radiographs, and the imaging features were analyzed. Results：The skeletal of all 12 cases Were abnormally changed. There were 12 cases of metaphyseal inflammation （including 6 cases of Wimberger＇ sign, two cases of pathological fractures）, 8 cases of osteomyetitis, 10 cases of periostitis, and 12 cases of soft tissue swelling. Others, such as skull, spine, and iliac crest showed no abnormal changes. The X-ray features of bone syphilis were extensive, multi-bone, symmetrical metaphyseal inflammation, periostitis, and osteomyelitis. Conclusion：There are certain characteristics in early congenital syphilis of bone. The bone damage often ap- peared before other clinical symptoms, especially in metaphysic. We believe which suspected congenital bone syphilis in children should be routine detect by long bone radiography examination, to provide a reference for early diagnosis, early treatment, and follow-up efficacy observed.