偶然发现:脊柱前纵韧带骨化描绘的全景x线片-一个病例报告与叙事回顾的文献

J. Aps, I. Koneski
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摘要

一名55岁男性患者在西澳大利亚大学牙科x线片上拍摄了全景x线片,显示了根尖周围病变、龋齿、牙齿骨折、牙周水平骨丢失以及颈椎前从C2到C4明显的骨化(部分)前纵韧带骨化(OALL)。鉴别诊断:骨赘和节段性骨关节炎。相关病史:机动车事故伴面部和牙槽外伤。随后,我们进行了一项叙述性的文献综述,以验证OALL的患病率和病因。PubMed®检索了骨化前纵韧带、foretier病和弥漫性特发性骨骼肥厚症(DISH)。还查阅了放射学手册。发现这种骨化,最初确定为老年性强直性骨质增生(foretier病),后来更名为DISH。其患病率在2.9%到25%之间。在76%的患者(典型的C4-C5水平)中,DISH的脊柱形式以累及颈椎的OALL为特征。颈椎OALL可伴有吞咽困难、阻塞性睡眠呼吸暂停和疼痛。节段性OALL和前椎体骨赘可与DISH混淆。其病因尚不清楚,但与高龄、肥胖和2型糖尿病有关。本病例强调了在牙科和颌面x线片上对颈椎(如果可见)进行评估的重要性,因为它可以向患者提出更有针对性的问题,转诊给医学专家,并有助于诊断未被注意或误诊的疾病。所描绘的前纵韧带
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Incidental finding: Ossification of the anterior longitudinal ligament of the spine depicted on a panoramic radiograph – A case report with narrative review of the literature
A 55-year-old male had a panoramic radiograph taken at the University of Western Australia Dental Radiographic assessment depicted periapical lesions, caries, fractured teeth, horizontal periodontal bone loss, and a distinct ossification anterior to the cervical spine stretching from C2 to C4: (partial) Ossification of the anterior longitudinal ligament (OALL). Differential diagnosis: Osteophytes and segmental OALL. Relevant patient’s history: Motor vehicle accident with facial and dentoalveolar trauma. Subsequently, a narrative literature review was conducted to verify the prevalence and etiology of OALL. A PubMed ® search was conducted for ossified anterior longitudinal ligament, Forestier disease, and diffuse idiopathic skeletal hyperostosis (DISH). Radiology handbooks were also consulted. It was found that this ossification, first identified as senile ankylosing hyperostosis (Forestier disease), was renamed later: DISH. Its prevalence varies between 2.9 and 25%. The spinal form of DISH is characterized by OALL with involvement of the cervical spine in 76% of patients (typical C4-C5 level). Cervical spine OALL can be associated with dysphagia, obstructive sleep apnea, and pain. Segmental OALL and anterior vertebral osteophytes can be confused with DISH. Its etiology is unknown, but associations have been suggested with advanced age, obesity, and type 2 diabetes mellitus. This case emphasizes the importance to include the assessment of the cervical spine, if visible, on dental and maxillofacial radiographs, as it may prompt more targeted questions toward patients, referral to medical specialists and help diagnose conditions that have been unnoticed or misdiagnosed. of the anterior longitudinal ligament of the depicted
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