摘要
目的总结椎管内占位误诊为幼年特发性关节炎(JIA)的原因和鉴别诊断。方法分析2009年1月—2019年1月椎管内占位误诊为JIA 9例的临床资料。结果9例中,因跛行就诊6例,肢体疼痛就诊2例,椎体局部疼痛就诊1例,均误诊为JIA。误诊时间为2~36个月。行脊椎MRI检查诊断为腰骶椎椎管内表皮样囊肿3例,蛛网膜囊肿2例,神经鞘瘤、皮样囊肿、椎管内脂肪瘤、胸椎椎管内皮样囊肿各1例。均行手术治疗并证实诊断,术后均恢复良好。结论腰椎椎管内占位患儿临床表现为关节疼痛、活动受限或跛行时易误诊为JIA。接诊医生应仔细查体,对可疑者应及时行相关医技检查以减少误诊。
Objective To summarize the causes and differential diagnosis of intraspinal space-occupying lesion misdiagnosed as juvenile idiopathic arthritis(JIA).Methods Clinical data of 9 patients with intraspinal space-occupying lesions misdiagnosed as having JIA between January 2009 and January 2019 was analyzed.Results Among the 9 patients,6 patients visited doctors for claudication,2 for limbs pain,and 1 for localized pain of vertebral body,and all of them were misdiagnosed as having JIA.The misdiagnosed duration was 2-36 months.After spinal magnetic resonance imaging(MRI)examinations,they were diagnosed as having lumbosacral spinal epidermoid cyst in 3 patients,arachnoid cyst in 2,schwannoma in 1,dermoid cyst in 1,intraspinal lipoma in 1 and thoracic intraspinal dermoid cyst in 1.All patients underwent surgical treatment,and the diagnosis was confirmed.All the 9 patients recovered well after the surgery.Conclusion Children with intraspinal space-occupying lesions are more likely to be misdiagnosed as having JIA when they have manifestations such as joint pain,limitation of activity or claudication.Clinicians should give physical examination carefully,and conduct relevant medical technical examinations in time so as to reduce misdiagnosis.
作者
苏改秀
吴凤岐
赖建铭
SU Gai-xiu;WU Feng-qi;LAI Jian-ming(Department of Rheumatology and Immunology,Capital Institute of Pediatrics,Beijing 100020,China)
出处
《临床误诊误治》
CAS
2021年第10期16-19,共4页
Clinical Misdiagnosis & Mistherapy
关键词
儿童
椎管内占位
误诊
幼年特发性关节炎
磁共振成像
Child
Intraspinal space-occupying
Misdiagnosis
Juvenile idiopathic arthritis
Magnetic resonance imaging
