Title

Usefulness of Bone Scan in Heterotopic Ossification

Translated Titles

骨骼掃描於異位性骨化症的價值

DOI

10.6332/ANMS.1803.003

Authors

黃永成(Yung-Cheng Huang);邱南津(Nan-Tsing Chiu);吳佩珊(Pei-San Wu);姚維仁(Wei-Jen Yao);李碧芳(Bi-Fang Lee);吳宜臻(Yi-Cen Wu)

Key Words

異位性骨化 ; 骨骼掃描 ; 異位性骨生成 ; heterotopic ossification ; bone scan ; hetero-topic bone formation

PublicationName

核子醫學雜誌

Volume or Term/Year and Month of Publication

18卷3期(2005 / 09 / 01)

Page #

143 - 148

Content Language

英文

Chinese Abstract

背景:異位性骨化症(heterotopic ossification HO)是在軟組織內有骨組織的異常生成。它的病因和病理學現仍不明確。HO最常隨著肌肉骨骼的創傷、脊髓損傷或者中樞神經受損而出現。HO的併發症有可能會造成關節活動性喪失甚至是關節硬化,進而導致功能上的受損,並且使得照顧這類病人更為困難。在疾病的初期,它與峰窩組織炎、骨髓炎、血栓靜脈炎及骨腫瘤的鑑別診斷是非常重要的。我們因而進行此項研究來探討骨骼掃描的效用以及骨骼掃描與HO臨床表現之間的相關性。 方法:我們回溯調查從1997年4月至2003年8月來到成大核醫部接受骨骼掃描的病人,記錄下那些由骨骼掃描診斷為HO病人的臨床資料(包括臨床的病程,實驗室生化的數值和影像檢查)以做分析探討。 結果:在臨床資料、骨骼掃描及其他影像診斷的證據下,有10位病患被確診為HO。藉由骨骼掃描,在這10位病患中,5位臨床上懷疑患有HO的病人因此得到確認,3位意外地發現HO,另2位病患則改變了其原本的臨床診斷(1位臨床上懷疑骨髓炎,1位懷疑骨頭腫瘤)。在這10位病患中的骨骼掃描,共有20處病灶被發現,有9處在髖關節,8處在大腿,3處在骨盆。從最初事件發生後到藉由骨骼掃描幫助診斷為HO之間的間隔為從1個月至19年不等(中位數是7.5個月)。 結論:骨骼掃描在HO的早期診斷上扮演著重要角色,特別是那些臨床表現上與其他疾病混淆不明(如骨髓炎),或者表徵不明顯的病人(如感覺受損的病人)。

English Abstract

Backgrounds: Heterotopic ossification (HO) is the abnormal development of bone tissue within soft tissue. Its etiology and pathology are uncertain. HO is seen most frequently with musculoskeletal trauma, spinal cord or CNS injury. Complications like loss of joint mobility or joint ankylosis may threaten function and make care of paraplegic patients difficult. The differential diagnosis of HO from cellulitis, osteomyelitis, thrombophlebitis or bone-forming tumor is crucial in its early stage. To explore the utility of bone scan for HO and its correlation with clinical findings we conducted the study. Methods: We retrospectively reviewed patients referred to our department for bone scans from April 1997 to August 2003. Clinical records, including clinical course, laboratory and imaging findings, were documented for those with scintigraphic diagnosis of HO. Results: Ten patients were proved to have HO by bone scans, other subsequent imaging studies and clinical course. Bone scans confirmed the diagnosis of HO in 5 clinically suspected patients, found HO was unexpectedly in 3 patients and changed the clinical diagnosis in 2 patients (1 clinically suspected of osteomyelitis, 1 clinically suspected of bone tumor). Totally twenty HO lesions were detected in the 10 patients. Their distributions were 9 in hip, 8 in thigh, 3 in pelvic cavity. Two patients had additional gallium scans which showed parallel findings to the findings of bone scans. The interval between the known initial event and scinti-graphic diagnosis of HO was 1 month to 19 years (The median interval is was 7.5 months). Conclusion: Bone scan plays an important role in the early detection of HO formation, especially for those with clinical manifestations mimicking other diseases (such as osteomyelitis), or not evident (such as in patients with impaired sensation).

Topic Category 醫藥衛生 > 基礎醫學
醫藥衛生 > 內科