纤维发育不良是一种罕见的良性骨疾病,其特征是用成纤维细胞和成骨细胞代替正常骨。我们介绍了一名25岁男性患者的单骨纤维发育不良病例。该病例突出了临床表现,射线照相特征,以及针对这种情况的管理方法。本报告旨在帮助理解纤维发育不良及其管理方案。一名25岁的男性表现为持续的左髋部疼痛。疼痛被描述为隐痛,与负重活动困难有关。没有外伤史或全身症状。体格检查显示左下肢外旋。由于疼痛,无法评估左髋关节的活动范围,没有发现神经功能缺损.初始成像包括右股骨的平片,表现出放射状病变,具有毛玻璃外观和皮质变薄。两个髋关节的磁共振成像显示涉及左股骨颈的不规则T2高强度和T1低信号病变;此外,病变内很少见微小的囊性间隙。部分病变延伸至股骨头上外侧,周围骨髓水肿,左髋关节积液最少,提示原发性骨肿瘤的特征。髋关节和骨盆的普通计算机断层扫描(CT)提示扩张性溶解性病变,其中骨间隔薄,左股骨头硬化边缘厚,大转子伴股骨颈下骨折,提示骨肿瘤(?巨细胞瘤>单纯性骨囊肿)。进行了骨活检,组织病理学检查证实了纤维发育不良的诊断,具有特征性的编织骨和纤维基质。在这种情况下,确诊后,患者接受左侧全髋关节置换术治疗.单骨纤维发育不良是一种罕见的良性骨疾病,可表现为各种临床表现。及时诊断,通过结合临床,射线照相,组织病理学评估至关重要。管理应根据患者的症状进行调整。
Fibrous dysplasia is a rare benign bone disorder characterized by the replacement of normal bone with fibroblastic and osteoblastic tissue. We present a
case of monostotic fibrous dysplasia in a 25-year-old male patient. The
case highlights the clinical presentation, radiographic features, and management approach for this condition. This report aims to contribute to the understanding of fibrous dysplasia and its management options. A 25-year-old male presented with a chief complaint of persistent left hip pain. The pain was described as a dull ache, associated with difficulty in weight-bearing activities. There was no history of trauma or constitutional symptoms. Physical examination revealed externally rotated left lower limb. Range of motion of the left hip could not be assessed due to pain, with no neurological deficits noted. Initial imaging included plain radiographs of the right femur, which demonstrated a radiolucent lesion with a ground-glass appearance and cortical thinning. Magnetic resonance imaging of both hip joints reveals an irregular T2 hyperintense and T1 hypointense lesion involving the left femoral neck; moreover, few tiny cystic spaces are seen within the lesion. Part of the lesion is extending into the superior-lateral aspect of the femoral head and surrounding bone marrow edema with minimal left hip joint effusion, features suggestive of a primary bony tumour. Plain computed tomography (CT) of the hip joint and pelvis was suggestive of an expansile lytic lesion with thin bony septation within and thick sclerotic margin in the left femoral head and greater trochanter associated with sub-capital femoral neck fracture suggestive of bone neoplasm (? giant cell tumour > simple bone cyst). A bone biopsy was performed, and histopathological examination confirmed the diagnosis of fibrous dysplasia, with characteristic woven bone and fibrous stroma. In this
case, after confirming the diagnosis, the patient was managed with total hip arthroplasty on the left side. Monostotic fibrous dysplasia is a rare benign bone disorder that can present with various clinical manifestations. Timely diagnosis through a combination of clinical, radiographic, and histopathological assessments is crucial. Management should be tailored to the patient\'s symptoms.