骨关节感染,慢性关节病和缺血坏死7.docx

Muscular and Skeleton System Yuefen zou Zou_yf@163.com Radiology DepartmentPeoples Hospital of Jiangsu Province Infection of bone, joint andsoft tissue ■化脓性骨髓炎(purulent osteomyelitis) ■金黄色葡萄球菌(staphylococcus aureus) ■ Infection pathway ■血行感染(haematogenous spread) ■直接延伸(direct extend) ■开放性骨折(open f racture) Acute Purulent Osteomyelitis Acute Purulent Osteomyelitis clinical symptom： pathology: metaphysis 一cortex of bone 一 subperiosteum abscess —medullary cavity of bone — sequestrum（死骨） —plerosis（修复） ■ X-ray film： Soft tissue； Muscle interspace clouding Subcutaneous fat clouding |i;one Destruction of bone Sequestrum （死骨） Parallel periosteal proliferation（平行骨膜反应） 理骨新， 理骨新， 成土覇（■ mg -oSBElu Acute Purulent Osteomyelitis ■ CT： it is better than X-ray plain film. 汩急性骨難炎：1 汩 急性骨難炎： 1 .骨肉：b .软组织窗： 胫骨骨内靄増生，骨髓腔密度増高骨癇变周囤软爼织帥胀. Acute Purulent Osteomyelitis ■ MRI： It is better than X-ray and CT. of the abscess shouldIt can make early diagnosis, low signal in T1WI and high signal in T2WL The wall of the abscess should be enhancement after injection of Gd-DTPA. 囂 F 6 2 fi. 15 4— 2. 如 2 音心性化脓性骨髓炎 su pin jring 73^/1. M. 2002.11.16 Jiangsu Province H ^^,-.394 MR 事 Jiangsu Prauince Hospital MR Mo?can C A厂I i+a Di iri iloni- dci-ar%m\/alii-ic I上 『 I上 『id * 双侧胫骨骨髓炎 Both tibiae acute purulent osteomyelitis Name ; Y闻 YOU WEI 34Y^HL Name:YAO YOU WEI 34嵐HL N3me;YMi YO J IdEI 34Y^HL FR N3me;Yjao YOU MEI 34Yf冃L DIM D23D7 No.:314S3 □oB 2002.09.05 rime:W：［B:D7 rirrie:W:DS:D7 No.:31482 P 如R C : 01342 W:D23D9 □oB 2002.00.05 口或匕加叩仙皿 C : 01334 FR I「Fl」 FR I E」 W : D2326 mi I rs , I iTvj I w ivici 1哄1 I LS , I L2 I W IMICI TTt 胫骨中下段感染 Chronic Purulent Osteomyelitis ■ X-ray： bone hyperplasia or sclerosis, diaphysis asper （粗糙），medullary cavity of bone narrow, destruction of bone, sequestrum ■ CT： similar to X-ray ■ MRI： hyperostosis osteosclerosis （骨质增 生硬化），sequestrum and periosteal proliferation are low signal. MRI can show abscess cavity and fistula cannulas （痿管）high signal. 慢性骨髓炎. 正侧位像）胫骨中上 段广泛