Multifocal bone infarcts combined with bone tuberculosis:3 cases report

YU Yi-pin; WANG Chong; TIAN Zheng; SONG Xing-hua; LI Wen-ju

doi:10.3969/j.issn.2095-252X.2013.09.012

Abstract：Objective To probe into the diagnosis and treatment of non decompression bone infarcts combined with bone tuberculosis. Methods 3 patients of multifocal bone infarcts and pain were collected. 1 case was of systemic lupus erythematosus ( SLE ) and treated with steriod. 1 case was of excessive drinking in alcohol. 1 case was of nephrotic syndrome and treated with steroid. Ingravescent pain occurred in all 3 patients from 3 month to 2 years about the knee joint. Active phthisis has not been found in X-ray test. Preoperative pain was evaluated by visual analogue scale ( VAS ). 10 lesions of bone infarcts were found by magnetic resonance imaging ( MRI ). 6 lesions might be infected because of some non-typical abnormal signal. The lesions accompanied by pain and non-typical abnormal signal were treated with surgical exploration, debridement, routine pathologic examination. Bone infarcts combined with bone tuberculosis was conifrm by pathologic diagnosis. Routine anti-tuberculosis therapy was used. Effects were observed. Postoperative pain was evaluated by VAS. Results Postoperative incision healing was good, local pain symptom was relieved, VAS scores reduced to 0-1 scale. No pain and recurrence was found in the follow-up ranged from 12 to 24 months. Conclusions Tuberculosis bacterium infection should be considered if pain suddenly aggravated in late bone infarction patients in high-incidence area of tuberculosis and MRI suggests non-typical abnormal signal. Treatment should be performed as what we did in bone and joint tuberculosis.