骨关节的影像学.docVIP

1.Acute pyogenic osteomyelitis ①Regional soft tissue swelling（局部软组织肿胀） near the site of involved bone is the only evidence for one or more weeks after the initial infection ②Cortical resorption may be identified radiographically as endosteal scalloping, intracortical tunneling, and poorly defined subperiosteal lucencies. ③Evident aggressive bone destruction（明显骨破坏） is ill-defined radiolucencies in the metaphysis surrounded by varying amounts of bony eburnation ④Infection may also spread along the entire length of the bone（感染沿着这个骨蔓延）, producing foci of destruction of varying sizes. ⑤Sinus tract formation（窦道形成） is common. ⑥The appearance of the periosteal proliferation accompanying osteomyelitis（骨膜增生伴随骨髓炎） is varied. A single thick layer \Single or multiple osseous shells, the onion skin appearance\ ⑦Sequestra（死骨形成） is formed in some cases of infection at acute stage Chronic pyogenic osteomyelitis ①Involucrum appears as strip of high density outside and parallel to the shaft ②Predominant bone sclerosis 明显的骨硬化 ③There is destruction as well as new bone formation（新骨的形成也有破坏） ④As a result of periosteal new bone formation（骨膜新生骨形成）, the bone is deformed and increased in density Two types of specific chronic osteomyelitis Brodie abscesses On radiographic examination, a Brodie abscess is radiolucent, sharply circumscribed, of variable size, and surrounded by bone sclerosis（局部边界清晰大小不等地脓肿形成，骨骺端有硬化带） Sclerosing osteomyelitis It is a form of subacute or chronic infection in which considerable periosteal bone formation surrounds the infected cortex and the trabeculae in the marrow increase in number and size骨皮质周围生成新骨，骨小梁增生，髓腔变窄 Supperative arthritis（老师说不是很重要） RADIOGRAPHIC FEATURES Radiographically, soft-tissue swelling is observed as a result of synovial hypertrophy and fluid accumulation. Joint-space narrowing reflects the pathologically evident cartilage destruction, and osseous erosions result from the action of the adjacent inflammatory pannus These erosions are usually seen