- 期刊
Primary Costochondritis or Osteomyelitis of the Ribs
原發性肋骨骨髓炎及軟骨炎
摘要
肋骨發炎的病灶往往來自外界創傷或因肋骨下肺實質感染或肋膜腔感染而次發性發炎。身體無其他病灶，而直接以肋骨骨髓發炎或軟骨發炎為表徵的病例，在文獻上很少報導。成功大學附設醫院自開院十年以來，共有此種疾病五例。病人年紀皆超過四十歲，其中女性只有一位。有一例病患有糖尿病史，並規律口服降血糖藥物治療，另一例病人在20年前有肺結核病史。除此之外，這些病人並無其他可追溯之醫療史或疾病。在這些病例傷口中，各培養出不同致病菌，胸部電腦斷層攝影或核磁共振攝影及核子醫學骨頭掃瞄皆有助於此疾病的診斷。早期診斷早期治療，是治療骨髓炎或軟骨炎的不二法門。仔細清除病灶外加全身性抗生素可以根除此項疾病。若有伴隨組織缺損或要減少細菌感染，局部肌肉皮瓣可善加利用。
關鍵字
無資料並列摘要
Rib infection is often secondary to trauma or from the direct spread of infection from the underlying lung or pleura. Primary costochondritis or osteomyelitis is rare in medical literature. We have treated 5 patients with these problems at NCKUH in the last ten years. All of the treated patients are older than 40 and only one patient was female. One patient was diagnosed with diabetes mellitus and received regular treatment, another one patient had pulmonary TB and was cured about 20 years ago. No other systemic problems can be traced during hospitalization. Different causative pathogens are cultured in these cases. CT scan, MR image and bone scan are helpful tools for pre-operative diagnosis although ultrasound is a more available modality. Wide excision and systemic antibiotics are cornerstones to cure these diseases, followed by muscle flap or omen-tum transfer to nourish the denuded bed and to restore the contour in selected cases.