Saggy scalp

Introduction Scalp scalp is a symptom of hypertrophic osteoarthrosis. The scalp is thickened and the cerebral palpebral fold is thick, the sulcus is obvious, and the longitudinal direction of the head is changed. This type of cerebral cerebral palsy is called scalp sag. The primary cause is unknown. Approximately 1/4 of patients with positive family history inheritance are transmitted through recessive or incomplete dominant genes, ie autosomal dominant inheritance with different penetrance. It has also been reported that abnormalities in chromosomes do not contribute to the genetics of the disease. Secondary: multiple secondary to lung and pleural diseases, cardiovascular disease and extrathoracic diseases.

Cause

1. Primary: The cause is unknown. Approximately 1/4 of patients with positive family history inheritance are transmitted through recessive or incomplete dominant genes, ie autosomal dominant inheritance with different penetrance. It has also been reported that abnormalities in chromosomes do not contribute to the genetics of the disease.

2. Secondary: multiple secondary to lung and pleural diseases, cardiovascular disease and extrathoracic diseases

(1) Lung or pleural disease: often secondary to bronchial lung cancer, pleural mesothelioma, chronic lung abscess, empyema, bronchiectasis, emphysema, lung metastases and lung lymphoma. In bronchial lung cancer, squamous cell carcinoma with cancerous cavity appears more common in this disease. The disease has nothing to do with the size and volume of lung cancer.

(2) Cardiovascular disease: often secondary to congenital cyanotic heart disease, pulmonary heart disease and bacterial endocarditis, such as tetralogy of Fallot, aortic Eisenmenger syndrome and congenital Arterial patent ductus arteriosus and the like.

(3) Extrathoracic diseases: including various extrapulmonary malignant tumors and no pulmonary metastasis, such as pancreatic cancer, esophageal cancer, nasopharyngeal cancer, etc., as well as cirrhosis, chronic ulcerative colitis, etc. caused by various reasons .

an examination

Related inspection

EEG blood test

1. X-ray examination: The main X-ray changes of this disease are long bone and short bone symmetry periosteal new bone formation. It can be expressed as parallel or layered, separated from the cortex by a linear translucent band, or as a fusion of the periosteal new bone with the original cortex, without a translucent band, wavy or extensive spinous periosteal callus. More common in the humerus, humerus, ulna, metacarpal, metatarsal bones, etc., the bones eventually involve all bones except the skull, and develop into ligaments and extensive ossification of the interosseous membrane, occasionally reported osteogenesis of the joints and spinal column Thin, osteoporosis. There are no abnormalities such as the saddle. The X-ray findings of primary and secondary hypertrophic osteoarthrosis are consistent.

2. Radionuclide examination: 99mTc-MDP bone imaging is more sensitive than X-ray photographs, often showing enhanced bone mineral metabolism in the distal bones of the extremities.

Differential diagnosis

Differential diagnosis of scalp sagging:

Hypertrophic osteoarthrosis has a typical clubbing, and there are no diagnostic problems. Sometimes other manifestations of hypertrophic osteoarthritis include skin manifestations before the clubbing, which is identified with the following diseases:

1. Acromegaly: The disease may have large hands and feet, thick skin, rough face, etc., easy to be confused with hypertrophic osteoarthrosis, but the disease does not have long bone and short bone periosteal new bone formation, the hand and foot is only increased Thickness, widening, no obvious increase, no significant increase in head circumference, increased growth hormone and serum inorganic phosphorus during active period, and most of the sella can be identified due to pituitary tumors.

2. Thyroid-like acromegaly: There are clubbing (toe), malignant eye and anterior mucinous edema. X-ray examination shows the formation of new bone under the periosteum of the metacarpal, which is more common when the treatment of hyperthyroidism causes hypothyroidism. The health history of hyperthyroidism can be identified.

3. Endosteal hypertrophy: The main manifestation is that the intimal hyperplasia causes cortical thickening and narrowing of the medullary cavity, and the transverse diameter of the bone does not increase. It often involves the skull to cause thickening of the skull and the barrier of the stenosis, and there is no sputum Finger and skin changes are different from hypertrophic osteoarthrosis. Others need to be differentiated from diseases such as rheumatoid arthritis and malformation osteitis.

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