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ID:19508343
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时间:2018-10-02
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1、NeuropathicOsteoarthropathyNeuropathicosteoarthropathyrepresentsaspectrumofboneandjointdestructiveprocessesassociatedwithneurosensorydeficit.diabetesmellitussyringomyeliasyphilisandotherneuropathiesradiologicfindingsOsteoarthritisInfectiontumorBothhypertrophicandatro
2、phicpatternsofneuropathicosteoarthropathyaredepictedradiologically.Theclassicallydescribedhypertrophicjointismanifestedradiologicallyasjointdestructionandfragmentation,osseoussclerosis,andosteophyteformation.Theatrophicformofneuropathicosteoarthropathyhasanappearance
3、ofosseousresorptionthatoftengivestheimpressionofsurgicalamputation.Theatrophictypemayappearsimilartosepticarthritis,andthehypertrophictype,asmentionedearlier,mayappearsimilartoosteoarthritis.Jointdisorganizationandlargepersistentbloodyjointeffusionarefeaturesofbothat
4、rophicandhypertrophictypesofneuropathicosteoarthropathy,and,whensevere,bothtypesexhibitdisorganizationmoreprofoundthanthatseeninotherformsofarthropathy.Milderdegreesofthedisease,however,maybedifficulttodiagnose.Fracturesareanimportantalthoughlesswell-knownmanifestati
5、onofneuropathicosteoarthropathy.Thesefracturesmayoccurspontaneouslyorinthepresenceofminortrauma.Neuropathicosteoarthropathyinthenon–weight-bearingjointsoftheupperextremityisrelativelyrarecomparedwiththatinthelowerextremity.Themostcommoncauseofaneuropathicshoulderissy
6、ringomyelia.Figure1a.Neuropathicosteoarthropathyoftheshoulderina45-year-oldmanwithasyrinx.(a)Frontal(anteroposterior)radiographdepictsosteolysisresemblingamputationwithsharplycircumscribedmargins.Normalmineralizationismaintainedintheremaininghumerus.Debrislinesthedis
7、tendedjointcapsule,subscapularrecess(blackarrow),andaxillaryrecess(whitearrow).(b)T1-weightedspin-echomagneticresonance(MR)image(repetitiontimemsec/echotimemsec = 500/20)ofthecervicalspinehelpsconfirmthepresenceofasyrinx(arrows).(FromtheAmericanCollegeofRadiology[ACR
8、]LearningFile,MSKcase235.)Figure2a.Initialdiagnosisofchondrosarcomaina76-year-oldwomanwasfoundtobeaneuropathicshoulder.(a)Frontalra
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