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病史摘要:患者男,30岁,左膝关节不适,关节下方疼痛2年左右;近2月疼痛加剧。骨科检查:左胫骨上端近关节处压痛明显,局部稍有肿胀,浮膑试验(-)。X线读片:左膝关节正、侧、斜位片(见插页图)。左胫骨顶端偏于外側,见一3.7×2.8cm大小的骨质脓坏区,内无钙化影,可见粗条状骨嵴,破坏区略呈膨胀改变,边缘连接光整,骨皮质变薄,部份可见硬化带,与正常的骨组织有明显的境界,周围无骨膜反应,软组织不肿胀,膝关节间隙及边缘正常。
Medical history summary: The patient is male, 30 years old, with left knee joint discomfort, pain below the joint for about 2 years, and pain intensification in recent February. Orthopedic examination: The tenderness at the proximal joint of the left tibia was obvious, and there was a slight swelling in the local part. The impetigo test (-) was performed. X-ray readings: left, right, oblique, oblique (see inset). The top of the left humerus is lateral to the side. See a erythema with 3.7 x 2.8cm in size. There is no calcification inside. The thick bones are seen. The destruction zone is slightly swollen. The edges are smooth and the cortical bone is thin. Some hardened bands were visible, and there was a clear realm with normal bone tissue, no periosteal reaction around, no soft tissue swelling, and normal knee clearance and margins.