Kümmell's Disease: A Case Report

Kümmell氏病：病例報告

李勝吉(Sheng-Chi Lee) ； 許建仁(Chien-Jen Hsu) ； 陳坤煌(Clement Kuen-Huang Cren) ； 葉力仁(Lee-Ren Yeh) ； 嚴智譯(Chih-I Yen) ； 黃志賢(Chi-Yin Wong)

《中華放射線醫學雜誌》 22卷6期 (1997/12) Pp. 255-258

摘要

Kümmell氏病，於1891年由Kümmell醫師首先報告，為脊椎受傷之後，形成遲發性脊椎體塌陷之病變。本文報告一病例，病患為七十歲男性，因跌倒引起背痛，當時脊椎X-光素片檢查為正常。由於持續背痛，磁振造影檢查嶺現第十二胸椎椎體完全被異常訊號所取代。此時臨床懷疑惡性轉移病灶。於是安排許多檢查皆未發現任何原發惡性腫瘤。其後追蹤脊椎X-光素片檢查，發現其第十二胸椎椎體輕微塌陷，經電腦斷層定位骨穿刺切片，病理報告證實為良性骨壞死。病患經保守治療約三個月後，症狀改善，且經四年追蹤，確無惡性腫瘤發生。最後診斷為Kümmell氏病。
Kümmell氏病在臨床上，由於缺乏完整病史以及系列放射線影像檢查，以致於確定診斷的病例很少。本病例因其具完整病史以及系列放射線影像檢查，加以特異性磁振造影影像，故提出此病例報告。

關鍵字

脊椎，電腦斷層 ； 脊椎，骨折 ； 脊椎，磁振造影

並列摘要

Kümmell's disease was first reported by Dr. Hermann Kümmell (German) in 1891. It was defined as the delayed posttraumatic collapse of a vertebral body. We report a case of a 70-year-old male with back pain after a falling injury. Initial radiographs of his thoracolumbar spine were interpreted as negative. Because of persistent back pain, magnetic resonance (MR) imaging of the spine and follow-up radiographs were performed which disclosed progressive collapse and total marrow replacement of the twelfth thoracic vertebra. Under suspicion of pathologic fracture, CT-guided biopsy was requested which confirmed diagnosis of delayed posttraumatic vertebral collapse.
Diagnosis of Kümmell's disease, a rarely reported disease, requires thorough history taking and serial imaging studies as was performed in this case. Since Kümell's disease may be mistaken for pathological fracture, characteristic MR enhancement pattern is helpful in early diagnosis.

並列關鍵字

Spine, CT ； Spine, fractures ； Spine, MR