Avaskularna nekroza glave femura nakon okultnog stres preloma vrata femura
Sažetak
Uvod. Osteonekroza (ON) glave femura (GF) – (ONGF) je bolest koju je teško kontrolisati, a izaziva progresivni kolaps GF, praćen jakim bolom i otežanim hodom. Prikazana je bolesnica sa avaskularnom nekrozom GF, nastalom usled okultne stres frakture vrata femura (VF). Prikaz bolesnika. Žena stara 55 godina javila se na Odeljenje, žaleći se na bol u leđima koji se širio u levu butinu u prethodna dva meseca. Bol u levoj butini se progresivno pojačavao tokom prethodne dve sedmice. Na radiografskim snimcima, kao i snimanjem kompjuterizivanom tomografijom, nije utvrđen patološki nalaz indikativan za ONGF ili okultnu frakturu VF, ali je snimanjem magnetnom rezonancom (MR) utvrđena okultna insuficijentna fraktura levog VF. Dijagnoza stres frakture VF nije postavljena, što je rezultiralo nekrozom GF. Bolesnici je urađena totalna artroplastika kuka, a uzorak GF je upućen na histopatološku (HP) analizu. Na osnovu HP nalaza, postavljena je konačna dijagnoza ONGF sa okultnom frakturom levog VF. Simptomi bolesnice su se povukli posle operacije, što je rezultiralo njenim kliničkim oporavkom. Zaključak. Kod bolesnika koji se prezentuju stanjem koje je sumnjivo na stres frakturu VF, preporučuje se rano snimanje MR, da bi se, usled odložene dijagnoze, izbegla nekroza GF.
Reference
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