膝关节周围软组织异物的临床病例:为医生提供帮助

Aleksey V. Kosyakov
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摘要

简介:人体器官中存在异物往往会给鉴别诊断和诊断验证带来困难。本文介绍了一例 45 岁女性患者的临床病例。经检查,患者主诉膝关节疼痛,活动范围受限,以左侧为重。关节疼痛综合征已存在数年,劳累时疼痛加剧;就诊前一周,患者从高处摔下,左膝关节感到剧烈疼痛。左膝关节的 X 光片显示,周围软组织中有碎裂的异物。患者否认有异物进入伤口的外伤史;她无法提供软组织中出现异物的数据和机制。结论:该临床病例的特殊之处在于没有关于异物进入伤口的数据,异物长期存在于软组织中,但没有明显的临床症状。然而,软组织中异物的相对罕见性并不排除它是疼痛综合征的病因,初级保健医生在诊断时应保持警惕。需要通过全面的病史采集和仪器检查来排除 X 光阴性异物的存在。没有一种检查方法可以被认为是诊断所有类型异物的理想方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Case of a Foreign Body in the Soft Tissues surrounding the Knee Joint: to Help the Practitione
INTRODUCTION: The existence of foreign bodies in a human organism often creates difficulties in differential diagnosis and diagnosis verification. A clinical case of a 45-year-old female patient is presented. On examination, the patient complained of pain in the knee joints, restricted range of active movements, more on the left. Pain syndrome in the joints has been present for several years intensifying on exertion; a week before the current consultation, the patient fell down from her height on the left knee and felt a sharp enhancement of pain in it. X-ray of the left knee joint showed a fragmented foreign body in the surrounding soft tissues. The patient denied a history of trauma with a foreign body getting into the wound; she cannot give the data and mechanism of appearance of a foreign body in the soft tissues. CONCLUSION: The peculiarities of the given clinical case include the absence of data on the fact of entry of a foreign body, its prolonged presence in the soft tissues without significant clinical symptoms. A relative rarity of a foreign body in soft tissues, however, does not exclude it being a cause of pain syndrome, the primary care physicians should have diagnostic alertness. A thorough history taking and instrumental examinations are required to exclude, among other things, the presence of an X-ray negative foreign body. Not a single method of examination can be considered ideal for diagnosis of all types of foreign bodies.
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