Greater trochanter tuberculosis
Introduction
Introduction to femoral TB Large femoral trochanter is commonly referred to as the greater trochanter of the femur. The femoral trochanter is located on the body surface, susceptible to chronic trauma, and there are many local cancellous bones. Therefore, femoral trochanteric tuberculosis is more common, accounting for 1.59% of total body and joint tuberculosis. More common in young adults aged 20 to 40. It is extremely rare to be under 10 years old. basic knowledge The proportion of illness: 0.001% Susceptible people: more common in young adults aged 20 to 40 Mode of infection: non-infectious Complications: swelling
Cause
Femoral trochanteric tuberculosis
Cause:
A devastating lesion caused by the invasion of bone by Mycobacterium tuberculosis. The large femoral trochanter is located on the body surface and is susceptible to chronic trauma. Due to the local cancellous bone, the femoral trochanteric tuberculosis is more common, accounting for 1.59% of the body's bone and joint tuberculosis. It is more common in young adults aged 20 to 40 years old. It is extremely rare under 10 years old.
Prevention
Femoral TB fever prevention
The disease is caused by tuberculosis invasion, as a complication of systemic tuberculosis, so actively treating tuberculosis and preventing the spread of pathogens is the key to preventing this disease.
Complication
Complications of femoral trochanteric tuberculosis Complications swelling
The complications of this disease are less reported. The hip joint activity is usually unobstructed. The slamming heel does not cause hip pain. Local swelling, abscess or sinus. If the lesion develops through the skin and forms the sinus, it is easy to follow. Infection, in some cases, the disease can also spread to the surrounding bone and joint capsule, causing the corresponding joint lesions.
Symptom
Common femoral tuberculosis symptoms common symptoms joint deformity joint pain bone destruction joint contracture muscle atrophy
The bursal-type femoral trochanteric tuberculosis is only characterized by swelling of the sac, and early bone destruction of the bone type is mild, and the thickness of the skeletal bone is thin. If the condition is taken, the lesion is difficult to find, and the patient is suspected of having the disease. According to the soft tissue conditions, using a variety of different angles to slash projection or fault, observe the swelling of the sac and bone destruction, can avoid missed diagnosis, the early symptoms of this disease is mild, local signs are not obvious, if the patient has a history of tuberculosis, local pain While the hip joints are normal, imaging should be actively performed. If necessary, local puncture or biopsy should be performed to confirm that CT is now widely used in clinical practice. If atypical patients can have CT examination, it will be diagnosed earlier. .
Examine
Examination of femoral TB
The examination methods of this disease mainly include the following aspects:
1. X-ray examination: the bone center type tuberculosis shows dead bone, the bone is formed after the dead bone is absorbed, and the edge type tuberculosis is mainly caused by osteolytic destruction. The sac tube type tuberculosis only sees soft tissue swelling and local bone decalcification.
2. Local puncture or biopsy is performed as necessary to confirm that CT is now widely used in clinical practice. If atypical patients are able to undergo CT examination, the diagnosis will be confirmed earlier.
Diagnosis
Diagnosis and diagnosis of femoral trochanteric tuberculosis
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
The disease should be identified with several diseases:
1. Bone metastases:
The patient's age ranged from 40° to 50°, and the general condition was mostly poor. The large trochanter was a good site for bone metastases. X-ray films showed osteolytic destruction, and pathological fractures were observed.
2. Skeletal primary tumor:
For example, giant cell tumor of bone.
3, rheumatoid large trochanitis:
Mostly bilateral, local swelling and tenderness, no abscess formation, X-ray film large trochanter edge is not neat, dense or small cystic changes.
4, chronic bone abscess:
Common in children and young people, lesions occur mostly at the junction of the upper trochanter and the upper end of the femur. X-ray film can show localized osteolytic destruction, no dead bone, dense bone around the damaged area, or mild periosteal reaction. .
5, suppurative osteomyelitis:
Suppurative osteomyelitis has significant periosteal hyperplasia and pupillary, but the dead bone is larger, and the repair signs are more prominent than tuberculosis. There are acute onset process and corresponding signs and laboratory results of suppurative osteomyelitis.
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