Sclerosing osteomyelitis

Introduction to sclerosing osteomyelitis Sclerosing osteomyelitis, also known as Garre osteomyelitis, Garre's disease, idiopathic cortical sclerosis and dry osteomyelitis, is less common. The cause has not been completely determined. It is generally considered to be a low-toxic infection of bone-published tissue, and has a strong osteogenic reaction. It is also believed that there are multiple small abscesses in the bone tissue at the same time, and the tension is high; the disease mostly occurs in the long tubular bone backbone. Take the tibia as a good site. The cause has not been completely determined. It is generally considered that the bone is a tissue with low toxicity and has a strong osteogenic reaction. It is also believed that there are multiple small abscesses in the tissue of the osteopath. The clinical feature of this disease is that after the bone tissue is infected, due to the strong osteogenesis reaction, it causes osteosclerosis, no osteonecrosis, suppuration, and no dead bone formation. Most of the long bone bone cortex is common in the femur or tibia. The cortical bone of one or both sides is thickened and hardened by the prism. In severe cases, the medullary cavity almost disappears, and the affected limb is gradually relieved by continuous pain. However, it is easy to recurrent, the systemic symptoms are not obvious, and the local part is sometimes asymptomatic or swollen. Inflammatory reactions such as pain, tenderness and pain are played at night than in the daytime, and the course of disease develops prolonged. It may be exacerbated by trauma or other diseases, but most of the joints are not affected. basic knowledge Sickness ratio: 0.0001% Susceptible people: no special people Mode of infection: non-infectious Complications: bone hyperplasia

Cause of sclerosing osteomyelitis

The etiology of this disease is unknown, it is difficult to find pathogenic bacteria, for the progressive, extensive and sclerosing inflammation of the bone, due to inflammatory reaction, extensive fibrosis occurs in the bone marrow cavity, blood circulation disorder occurs, oxygen tension in the bone decreases, and bone is promoted. Inferior epithelial bone-like tissue hyperplasia, deposition and calcification, Haser tube obstruction showed reactive endometrial thickening, and the cortical bone showed a series of pathological changes in fusiform hyperplasia.

Sclerosing osteomyelitis prevention

The cause of this disease is unknown, so there is no effective preventive measures at present, but it should be noted that for the treatment of this disease, conservative treatment can only temporarily relieve symptoms, and the use of thorough removal of the lesion and recanalization of the medullary cavity is an effective and preventive treatment. And the prognosis is good.

Sclerosing osteomyelitis complications Complications

The disease is prone to cause long-term chronic inflammation, while long-term chronic inflammation stimulates bone hyperplasia, bone tissue ischemia, hypoxia, or even stenosis or occlusion of the medullary cavity, while occlusion of the medullary cavity is a serious obstacle to blood circulation of the bone, increasing bone Internal pressure, so that the bone's resistance is lower, forming a vicious circle, so that the disease is prolonged and healed, repeated attacks, seriously affecting physical health and labor capacity.

Sclerosing myeloinflammation symptoms Common symptoms Weakness and pain Osteoporosis Periosteal reaction Bone destruction Dead bone

The clinical feature of this disease is that after the bone tissue is infected, due to the strong osteogenesis reaction, it causes osteosclerosis, no osteonecrosis, suppuration, and no dead bone formation. Most of the long bone bone cortex is common in the femur or tibia. The cortical bone of one or both sides is thickened and hardened by the prism. In severe cases, the medullary cavity almost disappears, and the affected limb is gradually relieved by continuous pain. However, it is easy to recurrent, the systemic symptoms are not obvious, and the local part is sometimes asymptomatic or swollen. Inflammatory reactions such as pain, tenderness and pain are played at night than in the daytime, and the course of disease develops prolonged. It may be exacerbated by trauma or other diseases, but most of the joints are not affected.

Examination of sclerosing osteomyelitis

Sclerosing osteomyelitis is a chronic bone infection characterized by low virulence infection, characterized by increased density of the medullary cavity, occlusion, and osteosclerosis. The clinical examination method is mainly X-ray examination, and its performance is mainly as follows:

Long bone localized or extensive osteoproliferative sclerosis, cortical thickening, medullary stenosis occlusion, generally no low-density destruction in the bone destruction zone, but a longer history may have small irregular bone destruction zone, osteomyelitis The bones around the destructive area are hardened, gradually migrate to the normal area, the endosteal is thickened, and the medullary cavity is narrowed, which is different from the tumor lesions.

There was no abnormal manifestation within 1 month at the beginning of the disease. The long-term thickening of the cortical bone showed dense, hardened, no obvious boundary with normal bone. The bone marrow cavity was narrower or occluded than normal, indicating that the medullary endocardium also had hyperplasia and new Bone formation.

Diagnosis and diagnosis of sclerosing osteomyelitis

diagnosis
X-ray films can be seen on a large number of bone dense hyperplasia, because the X-ray film shows a large white shadow of the paper, it is difficult to see the narrow marrow cavity and small translucent area. Layered film and CT examination can detect small translucent areas that are difficult to distinguish from ordinary X-ray films. There was no abnormal manifestation within 1 month at the beginning of the disease. The long-term thickening of the cortical bone showed dense, hardened, no obvious boundary with normal bone. The bone marrow cavity was narrower or occluded than normal, indicating that the medullary endocardium also had hyperplasia and new Bone formation.

Differential diagnosis

(A) sclerosing osteosarcoma: occurs in adolescents, found in the metaphysis but not in the backbone, there is radial hyperplasia and periosteal triangle, delay in treatment can occur lung metastasis.

(B) Ewing's sarcoma: patients with younger age, rapid development of the disease, like acute suppurative osteomyelitis, high fever, chills, severe pain, high serum AKP value, X-ray film shows that the cortical bone is onion-like changes, The bone marrow cavity is damaged and enlarged.

(3) Osteoid osteoma: The epithelial hyperplasia on the upper side of the backbone, with a small translucent area in the middle, nesting.

(4) syphilitic osteitis: blood Hua Kang positive, painless, multiple bone hyperplasia, bilateral symmetry.

(5) deformed osteitis: also known as Paget disease, occurs in the elderly, multiple, and lower extremities, the bone becomes thick and curved, the disease progresses slowly, the pain is not severe, may be local hypothermia, X-ray film shows cortical bone enlargement Thick, medullary cavity is also enlarged, the bones are slightly messy and irregular in texture, compensatory thickening in the convex side bone, serum AKP value is increased, blood calcium is normal.

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