镰状细胞病的骨骼X线表现

The Bone X-ray Manifestations of Sickle Cell Disease

目的探讨镰状细胞病(SCD)的骨骼X线表现。方法对经临床确诊的SCD合并骨骼改变的73例患者的X线表现进行分析。结果患者年龄1个月~25岁;X线表现包括骨质坏死60例,其中股骨头坏死20例,双侧同时坏死12例,同侧尺桡骨和掌骨同时坏死8例;骨髓增生12例,在短管状骨表现为骨骼外形变粗、变方形;骨质疏松4例,关节肿胀3例;25例呈骨髓炎征象,且16例呈双侧肢体对称发病,在长管状骨常合并病理性骨折。另外当病变累及两侧肋骨时,常合并双肺散在炎性灶。结论 SCD的共同特征是多见于黑色人种,发病年龄小,骨骼改变以骨质坏死和骨髓炎改变为主,但全身多处骨骼同时受累,且常对称性发病。

Objective To study the bone manifestations of sickle cell disease on X-ray. Methods 59 patients were discussed and analyzed for a study of the clinical diagnosis of sickle cell disease combined with bone manifestations on of Xray. Results Patients aged 1 month to 25 years old were included. X-ray manifestations including bone necrosis（ 60 cases）,20 cases of femoral head necrosis,12 cases of bilateral necrosis concurrently,the contralateral radius and metacarpal bone necrosis 8 cases synchronously; Bone marrow hyperplasia（ 12cases）,in short tubular bones of the skeleton showed thickening; Osteoporosis（ 4 cases）,joint swelling（ 3 cases）; 25 cases of osteomyelitic signs,16 cases of bilateral body asymmetry; In the long tubular bones manifestations often had intercurrent pathological fracture. In addition when lesions involving the ribs bilaterally often had intercurrent lung pneumonia. Conclusion The common features of sickle cell disease are found most commonly in the black race and at a young age of onset. Bone changes mainly display bone necrosis and osteomyelitis,but symmetrical synchronous multifocal body involvement is also common.