|
History: A teenage patient presents with head pain. 病史：青少年患者头痛。 CT images are shown below. CT图像如下所示。 Findings Extensive pan sinus disease with a thin layer of abscess along the outer table of the left frontal bone, as well as extensive soft-tissue swelling of the forehead, is seen, consistent with frontal bone osteomyelitis. Tiny medial left frontal pneumocephalus is consistent with intracranial extension of infection and likely presence of a tiny epidural abscess. 影像表现： 广泛鼻窦病变，沿左额骨外侧面可见薄层脓肿形成，前额大量软组织肿胀，提示额骨骨髓炎。左额部颅内少量积气，提示感染延伸至颅内，可见极少量的硬膜外脓肿。 Differential diagnosis
鉴别诊断：
Diagnosis: Pott's puffy tumor of scalp 诊断：波特氏头皮肿块 Key points Pott's puffy tumor of the scalp Pott's puffy tumor was first described in 1760 by English surgeon Sir Percival Pott. It is a complication of bacterial frontal sinusitis. Calvarial: Subgaleal abscess forms over osteomyelitis; usually due to frontal sinusitis. Infected cephalohematoma. 波特氏头皮肿块于1760首先被提出，是细菌性额窦炎的并发症。 颅骨：额窦炎引起骨髓炎，从而形成帽状腱膜下脓肿；感染性头部血肿。 Earliest image findings: Soft-tissue swelling next to bone Displacement or obliteration of fat planes 早期影像表现： 邻近骨的软组织肿胀 脂肪层移位或消失 Bony destruction is seen seven to 14 day (or longer) after onset. Vague lucency → permeation → destruction Periosteal reaction at seven to 10 days 发病后7-14天或至更长时间，可见骨质破坏。 模糊的透亮区 → 渗透性 → 破坏 7-10天可见骨膜反应 Chronic osteomyelitis: Sclerosis or mixed sclerotic/lucent, lucent tract extending through cortex, sequestrum (radiodense) 慢性骨髓炎：硬化或混合（硬化/透亮），骨皮质可见穿通的透亮带，死骨（不透X线） CT: Bone destruction, intracerebral gas and fat-fluid level, periosteal reaction, sequestrum Rim enhancement of intra- and extraosseous abscesses Bony destruction/sclerosis Surrounding soft-tissue swelling May show lucent tract through cortex, bony sequestrum CT表现： 骨质破坏，颅内积气并见脂液平面，骨膜反应，死骨； 骨内或骨外脓肿，环状强化； 骨质破坏/硬化 周围软组织肿胀 骨皮质可见穿通的透亮带，死骨。 MRI: Marrow edema, enhancement Abscess: Peripheral enhancement/central nonenhancement Large areas of surrounding edema in soft tissue/marrow Well-defined areas that do not enhance with gadolinium, suspect necrosis or abscess formation MRI表现： 骨髓水肿，有强化； 脓肿，外周强化，中心不强化； 软组织、骨髓可见大片状周围水肿； 不强化区域边界清楚，提示坏死或脓肿形成。 文献病例： |
|
|
来自： 昵称42715024 > 《头及颈部》
