頁籤選單縮合
題名 | Pyogenic Sacroiliitis Leading to Sciatic Notch Syndrome: Assessment with Magnetic Resonance Imaging=化膿性薦腸骨關節炎導致坐骨凹痕症候群及其核磁共振造影之特徵 |
---|---|
作者 | 林仙明; Lam, Sin-ming; |
期刊 | 中華民國風濕病雜誌 |
出版日期 | 19970500 |
卷期 | 14:1/2 民86.05 |
頁次 | 頁43-51 |
分類號 | 415.954 |
語文 | eng |
關鍵詞 | Pyogenic sacroiliitis; Sciatic notch syndrome; MRI; |
中文摘要 | 一位31歲女性病人因最近四天發燒及右側腎部劇痛並放射至右下肢而住院。過去有一年甲狀腺功能亢進並無定時治療。在半年前曾懷孕並產下一健康男嬰。理學檢查發現高燒到 38 ℃,血壓下降至 90/60 mmHg,心跳過速 (174/min)。右腎部有局部劇痛。 右大腿伸直後只能抬高到 15 度便會誘發劇痛。血液培養出葡萄球菌。 骨盆 X 光發現右側薦腸骨關節模糊。骨盆的核磁共振造影發現右側薦腸骨關節破壞合併關節前方及後方膿瘍壓迫到坐骨凹痕處之神經血管組織引起坐骨凹痕症候群。 經電腦斷層造影引導下以導管引流出 20 ml膿液,但膿液培養並無細菌發現。 經靜脈注射 Prostaphyllin 每天 8 gm 共四週,再追加Dicloxacillin 每天 1 gm 口服共二週後,病人可以自由活動。 |
英文摘要 | Pyogenic sacroiliitis is an uncommon, poorly localized disease which may be complicated by abscess formation. Delays in diagnosis and treatment are common and can lead to morbidity(1). We report on a case of a 32-year-old woman who presented with fever and right buttock pain radiating to the right lower leg of four days' duration. Her medical history included hyperthyroidism for one year with irregular treatment. She was six months postpartum. On examination, her blood pressure was 90/60 mmHg, pulse 174 beats/min, and temperature 38 ℃ . There was extreme tenderness in the right buttock area. Straight leg raising test of the right leg showed limited leg elevation (only 15 degrees). Staphylococcus aureus was isolated from cultures. Magnetic resonance imaging (MRI) of the pelvis showed bone erosion of the right sacroiliac (SI) joint with abscess formation along the anterior and posterior aspects of the right SI joint with compression of neurovascular bundle in the right sciatic notch resulting in right sciatic notch syndrome. Because of persistent fever and severe right buttock pain, computed tomography (CT)-guided drainage of the iliac abscess was done. About 20 ml of pus was aspirated but pus cultures were negative. The patient was treated with 8 gm of prostaphyllin/d intraveneously for 4 weeks followed by 1 gm of oral dicloxacillin/d for 2 weeks. After this, patient was ambulatory and could perform daily activities without back pain. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。