THOÁT VỊ ĐĨA ĐỆM THẮT LƯNG Ở TRẺ 14 THÁNG TUỔI BÁO CÁO CA BỆNH HIẾM GẶP TẠI BỆNH VIỆN VIỆT PHÁP HÀ NỘI=Lumbar disc herniation in a 14-month-old child: Report of a rare case at Viet Phap Hospital, Hanoi

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Tác giả: Công Hưng Bạch, Văn Sáng Cấn, Văn Tú Đỗ, Minh Thúy Nguyễn, Thế Hùng Nguyễn, Văn Khánh Nguyễn, Thị Nga Trần

Ngôn ngữ: vie

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Thông tin xuất bản: Tạp chí Điện quang và Y học hạt nhân Việt Nam, 2024

Mô tả vật lý: tr.82-87

Bộ sưu tập: Metadata

ID: 486988

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Mục đích: Mô tả đặc điểm lâm sàng, xét nghiệm, nguyên nhân và hình ảnh học của ca bệnh thoát vị đĩa đệm thắt lưng (TVĐĐTL), sau đó so sánh với các ca bệnh hiếm tương tự được mô tả trong y văn.Ca lâm sàng: Chúng tôi báo cáo một trường hợp hiếm gặp được chẩn đoán TVĐĐTL ở trẻ 14 tháng tuổi với nguyên nhân viêm đĩa đệm đốt sống (VĐĐĐS). Cộng hưởng từ (CHT) cho thấy rách vòng xơ và thoát vị đĩa đệm L5-S1 ra sau thể cạnh trung tâm bên trái. Được khẳng định không có chấn thương, đây là một trong những ca bệnh trẻ tuổi nhất được báo cáo trong y văn có nguyên nhân do VĐĐĐS.Kết luận: So sánh với các trường hợp hiếm gặp tương tự trong y văn, ca bệnh trên cho thấy sự tương đồng về đặc điểm lâm sàng và một số đặc điểm hình ảnh học. Sự khác biệt ở chỉ số viêm và phim CHT có tiêm thuốc phù hợp với nguyên nhân nhiễm trùng do VĐĐĐS.Mục đích: Mô tả đặc điểm lâm sàng, xét nghiệm, nguyên nhân và hình ảnh học của ca bệnh thoát vị đĩa đệm thắt lưng (TVĐĐTL), sau đó so sánh với các ca bệnh hiếm tương tự được mô tả trong y văn.Ca lâm sàng: Chúng tôi báo cáo một trường hợp hiếm gặp được chẩn đoán TVĐĐTL ở trẻ 14 tháng tuổi với nguyên nhân viêm đĩa đệm đốt sống (VĐĐĐS). Cộng hưởng từ (CHT) cho thấy rách vòng xơ và thoát vị đĩa đệm L5-S1 ra sau thể cạnh trung tâm bên trái. Được khẳng định không có chấn thương, đây là một trong những ca bệnh trẻ tuổi nhất được báo cáo trong y văn có nguyên nhân do VĐĐĐS.Kết luận: So sánh với các trường hợp hiếm gặp tương tự trong y văn, ca bệnh trên cho thấy sự tương đồng về đặc điểm lâm sàng và một số đặc điểm hình ảnh học. Sự khác biệt ở chỉ số viêm và phim CHT có tiêm thuốc phù hợp với nguyên nhân nhiễm trùng do VĐĐĐS.Purpose: To describe the clinical, lab tests, etiology and imaging characteristics of the lumbar disc herniation (LDH) case, then compare with similar rare cases described in the literature. Case-reported We report a rare case of LDH diagnosed in a 14-month-old child with spondylodiscitis (SpD). Magnetic resonance imaging (MRI) showed annular tear and left posterolateral disc herniation of L5-S. Confirmed having no trauma, this is one of the youngest cases reported in the literature with LDH caused by SpD. Conclusion Compared with similar rare cases in the literature, the above showed the similarities in clinical features and some radiological characteristics. The differences in lab tests of inflammation and MRI with contrast are consistent with an infectious cause due to SpD.Case reported: A 14-month-old male child showed a normal history of psychomotor development. Gross motor development is of normal by having stood firmly and learned to walk since 11 months old, then walked independently since 13 months old. The disease progressed within 1 week, then it demonstrated that the child limping and crying more and more. No history of trauma found, but a history of acute nasopharyngitis one week earlier noted. General examination showed neither fever nor other abnormalities at the moment of admission. Active movements demonstrated limitation by crying when standing and refusing to walk. Passive movements in supine position showed normality of both hip joints. No abnormalities of neurological, digestive systems or bladder function noted. Lab tests were normal initially. MRI showed a posteriolateral annulus disc tear at L5-S1 disc level, nucleus pulposus compressed the left L5 root, triggered an inflammatory reaction of the left S1 nerve and adjacent soft tissue. The child followed up after several days revealed worse clinical symptoms and high fever. Lab tests showed elevated erythrocyte sedimentation rate and white blood cell count. Second MRI with contrast confirmed the images of discitis.Conclusion: LDH is a very rare condition in young children. Rare cases reported in the literature almost always secondary to trauma. The case above is the youngest reported case of LDH due to SpD. Clinical and radiological features seemed similar when compared with similar rare cases in the literature.

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