METHODS: A 14-year-old woman was admitted because of persistent pain in the right hip and abnormal gait over the previous 2 mo. She had no history of present or past illness. Preoperative photography, enhanced computed tomography, and magnetic resonance imaging showed ground-glass appearance with cortical scalloping and expansion of the right proximal femur and femoral neck. Pathological examination by preoperative puncture biopsy revealed fibrous dysplasia of the right proximal femur. The patient was diagnosed with fibrous dysplasia based on medical history, physical examination, and results of laboratory, imaging and pathological examinations. According to final pathological examination, the patient was diagnosed with fibrous dysplasia of the right proximal femur associated with ABC. Curettage and allograft along with fixation of compression screws was performed for fibrous dysplasia associated with ABC-like changes. No obvious allograft absorption, loosening of fixation, or secondary fracture were observed during 6-months\' follow-up with re-examination by plain radiography and computed tomography. Fibrous dysplasia associated with ABC-like changes in the right proximal femur has a low incidence and early diagnosis is considered more difficult than for single fibrous dysplasia.
CONCLUSIONS: We report a cases of fibrous dysplasia associated with ABC-like changes in the right proximal femur treated with curettage and allograft along with hip compression screws.
方法:一名14岁的女性因前2个月的右髋部持续疼痛和步态异常而入院。她没有现在或过去的病史。术前摄影,增强计算机断层扫描,磁共振成像显示毛玻璃外观,皮质扇贝状,右侧股骨近端和股骨颈扩张。术前穿刺活检病理检查显示右股骨近端纤维发育不良。患者根据病史诊断为纤维发育不良,体检,和实验室的结果,影像学和病理学检查。根据最终病理检查,患者被诊断为与ABC相关的右股骨近端纤维发育不良.对与ABC样变化相关的纤维发育不良进行刮除和同种异体移植以及加压螺钉固定。无明显的同种异体移植物吸收,固定松动,在6个月的随访中观察到或继发性骨折,并通过X线平片和计算机断层扫描进行重新检查。与右股骨近端ABC样改变相关的纤维发育不良发生率低,早期诊断被认为比单个纤维发育不良更困难。
结论:我们报告了一例右股骨近端纤维发育不良与ABC样改变相关的病例,行刮治和同种异体髋关节加压螺钉移植治疗。