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1、胫骨结节骨软骨炎胫骨结节骨软骨炎胫骨结节骨软骨炎病因病理病因病理又名OsgoodSchlatter病。胫骨结节在婴儿期为软骨,1113岁左右出现骨化,在股骨前上方向下延伸呈舌状,覆盖胫骨近侧干骺端前方,1718岁与股骨近端骨骺融合,是髌韧带附着处并由其供血。反复多次的轻外伤及髌下股四头肌腱的强力牵拉是本病的主要原因。在外伤或剧烈运动时,由于髌韧带过度牵引使胫骨结节部分剥离,影响血液供应而发生坏死。髌韧带的损伤刺激纤维母细胞化生和成骨细胞的活动,使髌韧带及其附近软组织出现骨化、胫骨结节增大并向前突出。胫骨结节骨软骨炎临床表现临床表现本病好发于10-15岁男孩,常为单侧,亦可双侧发病。可有外伤史或
2、无明显外伤史,胫骨结节处疼痛,股四头肌用力时疼痛剧烈是本病的典型症状;胫骨结节处肿大并有压痛是典型体征。胫骨结节骨软骨炎影像表现特征影像表现特征(1)局部软组织肿胀为早期重要的基本征像,尤以髌韧带的增大或增厚为著。(2)胫骨结节骨骺呈舌样隆突或不规则增大,密度不匀,并节裂成多个大小、形态不一的游离骨块,而胫骨结节相对应的胫骨近侧干骺端前缘常有较大的骨缺损区。(3)髌韧带中可产生继发性钙化或骨化,呈游离的圆形、卵圆形或三角形阴影。(4)结合临床,本病诊断不难,但常需与健侧对照观察。胫骨结节骨软骨炎鉴别诊断鉴别诊断需与胫骨结节撕脱性骨折鉴别。与撕脱骨片不同之处是与骨块相对应的干骺端骨缺损处较大,且
3、边缘较光滑。另外游离骨块的边缘也较骨折片完整。胫骨结节骨软骨炎局部软组织肿胀,髌韧带中见多块骨化影,胫骨结节密度增高,并有碎裂。胫骨结节骨软骨炎胫骨结节呈舌样隆突,密度增高,胫骨近侧干骺端前缘有较大的骨缺损区,前方组织肿胀。胫骨结节骨软骨炎胫骨结节不规则增大,密度增高,前方组织肿胀,髌韧带中有多个骨化阴影。胫骨结节骨软骨炎胫骨结节骨软骨炎胫骨结节骨软骨炎胫骨结节骨软骨炎胫骨结节骨软骨炎谢谢胫骨结节骨软骨炎8Ty&U3Wu%o8EOorXhe3rcAfov+DTkOUzawliWBw#Qh&Ux$6LACvmxtBDm)E!uG6BHqSlGvXZ$9S9Gbp7sr3VsoI6a6dDn7!N
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