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非特异性肋软骨炎

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概述编辑本段回目录

  一般认为非特异性肋软骨炎是一种非化脓性肋软骨肿大,女性发病略多,多位于第2-4肋软骨,单侧较多本病病因不明。主要临床表现为肋软骨局限性疼痛。如果疼痛区肿胀,则被称为Tietze病。

医学百科网-MedBaike. com

病因编辑本段回目录

  (一)发病原因 医学百科网-MedBaike. com

  本病病因不明,1921年Tietze首先报道此病,故也称为Tietze病??赡苡胍韵乱蛩赜泄兀?

医学百科网-MedBaike. com

  1.多数患者发病前有上呼吸道感染史,有学者认为可能与病毒感染有关。

医学百科网-MedBaike. com

  2.可能与胸肋关节韧带慢性劳损有关。

医学百科网-MedBaike. com

  3.可能与内分泌异常引起肋软骨营养障碍有关,因此也称本病为营养障碍性肋软骨萎缩症。 医学百科网-MedBaike. com

  4.肋软骨的组织学检查正常,只是发育较粗大,有人也称作肋软骨增生症。 医学百科网-MedBaike. com

症状体征编辑本段回目录

  无菌性肋软骨炎多见于青年人,女性多发。发病前多有呼吸道感染史,病变多侵袭单根肋软骨,受累的肋软骨肿大隆起,局部压痛明显,但无细菌感染时的表皮红热征。偶见多根及双侧受累,发生部位多在胸骨旁的2~4肋软骨,以第2肋软骨最常见。诉局部疼痛,活动加剧,持续时间长短不一,3~4周后可自行消失。但常反复发作,迁延数月甚至几年。轻者仅感轻度胸闷不影响正常工作,严重时肩臂俱动,甚或牵及半身。

医学百科网-MedBaike. com

诊断编辑本段回目录

  青年女性,近期有呼吸道感染史,胸骨旁的2~4肋软骨肿大隆起,局部压痛,X线检查无异常改变,诊断不难。 医学百科网-MedBaike. com

检查化验编辑本段回目录

  X线片因肋软骨不能显影,故对诊断无帮助,但可排除胸内病变、肋骨结核或骨髓炎等。

医学百科网-MedBaike. com

鉴别诊断编辑本段回目录

  因局部有肿胀、凸起及疼痛,应与肋软骨肿瘤、胸壁结核、骨折后骨痂形成等鉴别。

医学百科网-MedBaike. com

治疗编辑本段回目录

  一般采用对症治疗,如局部利多卡因加氢化可的松封闭或于肋软肋肿大处骨膜刺孔减张等,有一定效果。一般对理疗和抗生素疗郊不明显。若长期应用各种治疗无效,且症状较重或不能排除肿瘤可能时,可将肋软骨切除。 医学百科网-MedBaike. com

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