易被误诊的踝关节结核1例
摘要
<正>踝关节结核约占全身骨关节结核的4%,易形成窦道,严重影响踝关节的运动功能~([1-4])。由于踝关节结核发病率相对较低,因此不被人们重视,易被误诊。另外,关于踝关节结核治疗的报道也较少,传统方法为切开刮除病灶,或使用石膏外固定达到融合目的,很少有使用内固定的报道~([4-8])。本文报道1例踝关节结核的诊断和手术治疗,并总结了相关经验和教训。1病历资料患者,男性,已婚,51岁,职工。因"左踝外
引文
[1]Wallis RS,Maeurer M,Mwaba P,et al.Tuberculosis-advances in development of new drugs,treatment regimens,host-directed therapies,and biomarkers[J].Lancet Infect Dis,2016,16(4):e34-e46.
[2]Dhillon MS,Nagi ON.Tuberculosis of the foot and ankle[J].Clin Orthop Relat Res,2002,398(398):107-113.
[3]Raviglione MC,Snider DE Jr,Kochi A.Global epidemiology of tuberculosis.Morbidity and mortality of a worldwide epidemic[J].JAMA,1995,273(3):220-226.
[4]彭旭,段小军,杨柳,等.踝关节镜下微创治疗踝关节结核的临床疗效[J].中华关节外科杂志(电子版),2012,6(4):554-560.
[5]Tang X,Zhu J,Li Q.Knee arthrodesis using a unilateral external fixator combined with crossed cannulated screws for the treatment of end-stage tuberculosis of the knee[J].BMC Musculoskelet Disord,2015,16:197.
[6]Chen MY,Lo YC,Chen WC,et al.Recurrence after successful treatment of multidrug-resistant tuberculosis in Taiwan[J].PLo S One,2017,12(1):e0170980.
[7]Gursu S,Yildirim T,Ucpinar H,et al.Long-term follow-up results of foot and ankle tuberculosis in Turkey[J].J Foot Ankle Surg,2014,53(5):557-561.
[8]Chen SH,Lee CH,Wong T,et al.Long-term retrospective analysis of surgical treatment for irretrievable tuberculosis of the ankle[J].Foot Ankle Int,2013,34(3):372-379.
[9]Lin RC,Lu KH,Lue KH.Adjuvant arthroscopy for ankle tuberculosis:a report of two cases[J].Foot Ankle Int,2009,30(1):74-79.
[10]Werner BC,Burrus MT,Park JS,et al.Trends in ankle arthroscopy and its use in the management of pathologic conditions of the lateral ankle in the United States:a national database study[J].Arthroscopy,2015,31(7):1330-1337.
[11]Guo L,Yang L,Duan XJ,et al.Arthroscopically assisted treatment of adolescent knee joint tuberculosis[J].Orthop Surg,2010,2(1):58-63.
[12][Sawlani V,Chandra T,Mishra RN,et al.MRI features of tuberculosis of peripheral joints[J].Clin Radiol,2003,58(10):755-762.
[13]Inoue S,Matsumoto S,Iwamatsu Y,et al.Ankle tuberculosis:a report of four cases in a Japanese hospital[J].J Orthop Sci,2004,9(4):392-398.
[14]Johansen IS,Nielsen SL,Hove M,et al.Characteristics and clinical outcome of bone and joint tuberculosis from 1994 to 2011:a retrospective register-based study in Denmark[J].Clin Infect Dis,2015,61(4):554-562.
[15]邹剑,施忠民.中足结核分期手术的疗效评估[J].足踝外科电子杂志,2014,1(2):130-134.
[16]Duan X,Yang L,Yin L.Arthroscopic arthrodesis for ankle arthritis without bone graft[J].J Orthop Surg Res,2016,11(1):154.
[17]蒋逸秋,潘竹,李杨,等.踝关节镜技术治疗弥漫性类风湿关节炎的临床疗效分析[J].足踝外科电子杂志,2016,3(1):34-36.
[18]Mittal R,Gupta V,Rastogi S.Tuberculosis of the foot[J].J Bone Joint Surg Br,1999,81(6):997-1000.
[2]Dhillon MS,Nagi ON.Tuberculosis of the foot and ankle[J].Clin Orthop Relat Res,2002,398(398):107-113.
[3]Raviglione MC,Snider DE Jr,Kochi A.Global epidemiology of tuberculosis.Morbidity and mortality of a worldwide epidemic[J].JAMA,1995,273(3):220-226.
[4]彭旭,段小军,杨柳,等.踝关节镜下微创治疗踝关节结核的临床疗效[J].中华关节外科杂志(电子版),2012,6(4):554-560.
[5]Tang X,Zhu J,Li Q.Knee arthrodesis using a unilateral external fixator combined with crossed cannulated screws for the treatment of end-stage tuberculosis of the knee[J].BMC Musculoskelet Disord,2015,16:197.
[6]Chen MY,Lo YC,Chen WC,et al.Recurrence after successful treatment of multidrug-resistant tuberculosis in Taiwan[J].PLo S One,2017,12(1):e0170980.
[7]Gursu S,Yildirim T,Ucpinar H,et al.Long-term follow-up results of foot and ankle tuberculosis in Turkey[J].J Foot Ankle Surg,2014,53(5):557-561.
[8]Chen SH,Lee CH,Wong T,et al.Long-term retrospective analysis of surgical treatment for irretrievable tuberculosis of the ankle[J].Foot Ankle Int,2013,34(3):372-379.
[9]Lin RC,Lu KH,Lue KH.Adjuvant arthroscopy for ankle tuberculosis:a report of two cases[J].Foot Ankle Int,2009,30(1):74-79.
[10]Werner BC,Burrus MT,Park JS,et al.Trends in ankle arthroscopy and its use in the management of pathologic conditions of the lateral ankle in the United States:a national database study[J].Arthroscopy,2015,31(7):1330-1337.
[11]Guo L,Yang L,Duan XJ,et al.Arthroscopically assisted treatment of adolescent knee joint tuberculosis[J].Orthop Surg,2010,2(1):58-63.
[12][Sawlani V,Chandra T,Mishra RN,et al.MRI features of tuberculosis of peripheral joints[J].Clin Radiol,2003,58(10):755-762.
[13]Inoue S,Matsumoto S,Iwamatsu Y,et al.Ankle tuberculosis:a report of four cases in a Japanese hospital[J].J Orthop Sci,2004,9(4):392-398.
[14]Johansen IS,Nielsen SL,Hove M,et al.Characteristics and clinical outcome of bone and joint tuberculosis from 1994 to 2011:a retrospective register-based study in Denmark[J].Clin Infect Dis,2015,61(4):554-562.
[15]邹剑,施忠民.中足结核分期手术的疗效评估[J].足踝外科电子杂志,2014,1(2):130-134.
[16]Duan X,Yang L,Yin L.Arthroscopic arthrodesis for ankle arthritis without bone graft[J].J Orthop Surg Res,2016,11(1):154.
[17]蒋逸秋,潘竹,李杨,等.踝关节镜技术治疗弥漫性类风湿关节炎的临床疗效分析[J].足踝外科电子杂志,2016,3(1):34-36.
[18]Mittal R,Gupta V,Rastogi S.Tuberculosis of the foot[J].J Bone Joint Surg Br,1999,81(6):997-1000.