Bone-Cancer课件-54页课件资料.pptVIP

BoneCancerB2:于强马宁丹费良晨张莹莹肖崇珺王超穆淑坤徐俊彦符筱笛张燕范晶炎陈壁俊童越黄鑫

Content1.Casedescription2.Dignosisprogress3.Treatment4.Newfinding1.ChiefComplaint2.History3.PhysicalExaminationVitalsignsI.P.M.M.

Chiefcomplaint主述Tang，female，15-year-oldSwellingpainonlowerrightthighforover4months.右大腿下侧胀痛4月余

History病史4月前无明显诱因觉右大腿下段肿痛(swellingpainonlowerrightthigh)?，呈持续性钝痛?(persistentdullpain)，无规律，活动后加重，休息后减轻?。有时感膝关节胀痛，夜间疼痛明显(aggravatedatnight)，关节活动正常?。约一月前发现右大腿下段外侧一肿块渐增大(graduallyincreasedmass)，夜间疼痛加重；无头痛、头晕、胸痛、呼吸困难；无右下肢麻木。发病以来，无寒战、发热?，精神睡眠可，大小便正常，体重无明显变化。否认外伤史，过敏史。

PhysicalExaminationVitalsigns：Temp(体温)36.5℃PR(脉搏)76/minBR(呼吸)17/minBP(血压)110/75mmHg

第一PPT模板网，PPT素材下载1ppt/sucai/右膝上十公分范围轻压痛（tenderness），皮温稍高PalpationMPIM轻度跛行（limp），右膝关节无畸形（malformation）及肿胀，皮肤无发红，无静脉怒张（veindistention）。Inspection膝关节活动度正常，右下肢感觉运动正常Motion双下肢等长MeasurePhysicalExamination

Content1.Casedescription2.Dignosisprogress4.Newfinding1.InitialImpression2.Imflammationthreerountinetests3.TumorChermicaltestX-Ray,MRI,RadioisotopeScan4.AxtraExamination5.DifferentialDignosis3.Treatment

InitialImpressionInitialImpression1.AcuteInfection蜂窝织炎、化脓性骨髓炎2.ChronicInfection骨关节炎、膝关节滑囊炎3.SpecificInfection结核Inflammation脂肪瘤、血管瘤、骨巨细胞瘤、骨肉瘤、尤文肉瘤、骨肿瘤样变...Tumor

AuxiliaryExaminations1.三大常规

Bloodtest:

WBC:5.6G/L,

neutrophil:60%,RBC:4.2T/L,

Hb:140G/L,PLT:140G/L.

urineandstooltestarenormal.

ESR:96mm/h.

hepatitisB:negative1.Physiologicalconditions:月经周期，妊娠期，60y2.Pathologicconditions:急慢性感染、高蛋白血症、恶性肿瘤无炎症反应

Non-specific：蜂窝织炎化脓性骨髓炎骨关节炎膝关节滑囊炎...Specific：BoneTBBenign：骨样骨瘤骨软骨瘤...Malignant：骨肉瘤转移瘤尤因肉瘤...骨巨细胞瘤moreevidencesneededInflammationTumor

RadioisotopeScanX-Ra