骨样骨瘤1例的康复与临床进展

S. Iluț, G. Dogaru, Oana Mureșan, D. Muresanu
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引用次数: 0

摘要

介绍。骨样骨瘤约占所有原发性骨肿瘤的3%,占所有良性骨肿瘤的11%。文献资料显示,类骨骨瘤手术后的神经肌肉康复计划是非常有益的,可以提高总体生活质量。材料和方法。一位30岁男性患者,在过去的一年里,间歇性右肩疼痛放射到右手,并反复出现肌痛,来到我们的神经科。神经学检查显示右上肢外展受限。临床旁检查包括右上肢x线平片和神经电图,均正常,颈椎MRI显示离散C5椎间盘溢出,无明显压迫迹象。患者最初对非甾体抗炎药的反应有限,因此改为类皮质激素治疗。此外,患者被引导进行风湿病学检查,其中进行了肌肉骨骼超声检查,未显示任何特定的改变。此外,我们指出了原生右肩MRI,显示肱骨近端骨干信号改变。我们进一步指示对右上肢进行MRI扫描,显示肱骨顶部三分之一处有一个病灶。此外,同一区域的CT扫描显示高度提示骨瘤的图像。患者被转诊到骨科,在那里进行了肿瘤的完全切除,病理报告证实了最终诊断为类骨骨瘤。结论。类骨骨瘤手术后,如果神经肌肉康复计划与矫形装置和止痛药相结合,对增强肌肉力量有重要作用,则恢复更有益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Rehabilitation and clinical evolution aspects in a case of Osteoid Osteoma
Introduction. Osteoid osteoma represents about 3% of all primary bone tumors and 11% of all benign bone tumors. Data from the literature suggest that a neuromuscular rehabilita-tion program after osteoid osteoma surgery is very beneficial and improves the general quality of life. Material and methods. A 30-year-old male patient with intermittent right shoulder pain radiating to the right hand, and recurrent myalgias in the past year presented to our neuro-logical department. The neurological examination highlighted limitation of the abduction of the right upper limb. The paraclinical investigations included plain radiography of the right upper limb and electroneurography, which were normal, and native cervical MRI which revealed discrete C5 disc overflow, without visible signs of compression. The patient presented limited initial response to NSAIDs, so his treatment was changed to corticoster-oid therapy. Further, the patient was guided to undergo a rheumatological examination where a musculoskeletal ultrasound was performed, showing no any specific modifica-tion. Additionally, we indicated a native right shoulder MRI, which revealed a signal mod-ification of the proximal humeral diaphysis. We further indicated an MRI scan with con-trast of the upper right limb, which revealed a nidus at the top one-third of the humerus. Additionally, a CT scan with contrast of the same region displayed images that were high-ly suggestive of osteoma. The patient was referred to the orthopedics department, where a complete resection of the tumor was performed, and the pathology report confirmed the fi-nal diagnosis of osteoid osteoma. Conclusions. Recovery after osteoid osteoma surgery is more beneficial if the neuromuscu-lar rehabilitation program, that has an important role in increasing muscle strength, is combined with orthopedic devices and pain medication.
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