橈骨遠位端に生じたサルモネラ骨髄炎の1例

Salmonella Osteomyelitis of the Distal End of the Radius. Case Report

　われわれは基礎疾患を伴わない橈骨遠位端サルモネラ骨髄炎を経験した．症例は18歳の女性で主訴は右手関節痛であった．単純X線像で橈骨遠位端に溶骨性変化を認め，CTでは皮質骨まで達する境界不明瞭な溶骨性変化を呈する腫瘤を認めた．腫瘤性病変はMRIのT1強調像で低信号，T2強調像で不均一な高信号を呈した．CTガイド下針生検術を行ったところ，病理検査で炎症細胞浸潤と線維化を認め，培養でSalmonella O7が同定された．便培養は陰性であった．骨移植を併用しない病巣掻爬と抗生剤投与で治療を行ったが経過良好である．

　We report a case of Salmonella osteomyelitis of the distal metaphysis of the radius. An 18-year-old female was referred to our hospital with a chief complaint of right wrist pain. A cystic lesion was observed in the distal metaphysis of the radius on both plain radiographs and CT scans. The cystic lesion was low signal intensity on the T1-weighted MRI scans and heterogeneous high signal intensity on the T2-weighted images. CT-guided needle biopsy was performed, and histological examination of the biopsy specimen revealed inflammatory cells and fibrous change. Salmonella O7 was cultured from the biopsy specimen but no Salmonella were cultivated from the patients stools. Antibiotic therapy was performed and followed by curettage without bone grafting. There is no evidence of infection at present.