Freiberg's Disease Involving Third Metatarsal Bone Noted by Bone Scan: A Case Report

骨骼掃描對於評估有骨頭疼痛的病人是一項敏感度很高的檢查，尤其是當其它臨床或影像學檢查不足以診斷時，或許可以提供額外有用的資訊。一位64歲的婦女因左足痛至本院骨科求診，除骨痛外無其他任何症狀。由於足部X光攝影發現的骨折並無法解釋病人持續無改善的疼痛，病人做了全身骨骼掃描，發現左邊第三蹠骨尤其在蹠骨頭的部位有局部的放射性示蹤劑攝取增加。回顧病人的病史，病人足部受到長期反覆性的壓力，因此我們懷疑有蹠骨無菌性壞死（Freiberg氏疾病）的可能性，而稍後的磁振造影檢查則懷疑是慢性骨髓炎。最後經由切片證實是第三蹠骨的骨壞死。這個個案呈現一個骨壞死發生在罕見的位置，而典型的放射性示蹤劑攝取形式幫助了診斷，骨骼掃描可當作一項初步，非侵襲性的檢查工具，以評估病人是否需要接受進一步的處置。

關鍵字

Freiberg氏疾病； Freiberg氏不全骨折；第三蹠骨；骨骼掃描；骨壞死

並列摘要

Bone scan is a sensitive tool for evaluating cause of bone pain in symptomatic patients especially when other clinical or imaging modalities can not provide enough information for diagnosis. A 64-year-old woman visited our orthopedic department complaining of left foot pain without other signs or symptoms. Due to persistent pain which was unresponsive to treatment and unexplained by X-ray finding of fracture, the patient underwent a whole body bone scan. The scintigraphic finding showed focally increased radiotracer uptake at the third left metatarsal bone especially in the head region. In view of clinical history, there was long-term repetitive stress on the patient's feet; therefore, we suggested the possibility of aseptic necrosis (Freiberg disease). Finally, a biopsy was done and the pathology revealed osteonecrosis of the third left metatarsal bone. Our case demonstrates an uncommon site of osteonecrosis with a typical pattern of radiotracer uptake which assisted in the diagnosis of osteonecrosis. Furthermore, bone scan serves as an initial and non-invasive role in determining the need for further management.

並列關鍵字

Freiberg disease ； Freiberg infraction ； third metatarsal bone ； bone scan ； osteonecrosis

國際替代計量

Freiberg's Disease Involving Third Metatarsal Bone Noted by Bone Scan: A Case Report

全文下載

主題瀏覽