CC BY
19mediterranean journal
of RHEUMATOLOGY
eaahnikh peymatqaoria
26 1
2015
KAINIKO nPOBAHMA CLiNiCAL PROBLEM
OoQuaÄYia oe veapn YuvaiKa
Eua rewpYlou, MD, Mapiavva BAuxou1, MD, PhD, KwvoTavTivoq Oouvraq2, MD, PhD, AaZapoq I. laKKaq, MD, DM, PhD(UK)
PeupaToXoYiKH KAiviKn, 1EpYaoTnpio AKTivoAoYiaq, 2NeupoxeipoupYiKn KAiviKn, laTpiKO TMnMa, ^xoAr] EnioTnM^v YYeiaq, navenioTHMio GeooaAlaq Kai navenioTHMiaKÖ reviKO N000K0Mei0 Aapioaq
Low back pain in a young woman
Eva Georgiou, MD, Marianna Vlychou1, MD, PhD, Konstantinos Fountas2, MD, PhD, Lazaros I. Sakkas, MD, DM, PhD(UK)
Department of Rheumatology, 1Radiology and Neurosurgery, Faculty of Medicine, School of Health Sciences, University of Thessaly and University General Hospital of Larissa
To nepiOTaoTiKÖ: TuvaiKa nAiKiaq 22 eTwv npoonA9e oTo e^wTepiKö peuMaToAoYiKö iaTpeio oTa TeAn Auyoüotou 2014 Me oo0uaAYia Kai avTaväKAaon oto YÖvaTo ap anö 5Mnvou. Anö to iotopikö, eTepöZuYoq ß-MeooYeiaKn avaiMia, xoAoKuoTeKToMn, 9upoeiSona9eia. Aöyw Tnq oo0uaAYiaq unoßAn9nKe oe MRI (EiKÖva) Kai voonAeü9nKe oe aAAn KAiviKn. EKei, oi YeviKeq e^eTäoeiq, to MueAÖYpaMMa, o KuTTapoYeveTiKÖq eAeYxoq MueAoü twv ootwv, KapKiviKoi SeiKTeq (Ca19-9, Ca15-3, CEA, Ca125, calcitonin) Kai aneiKovioTiKÖq eAeYxoq 9wpaKoq Kai KoiAiaq Sev eSei^av SiaTapaxn. ^XÖAio: oo0uaAYia eivai Koivö oüMnTWMa Kai ouvn9wq u0ieTai xwpiq AeiToupYiKeq ouveneieq. Mnopei va o0eiAeTai oe KaTanövnon Muwv, eK0uAioTiKeq aAAoiwoeiq ano0uoiaKüv ap9pwoewv, räTaYMa H aAAn ßAäßn onovSuAwv, KnAn MeooonovSuAiwv SioKwv, ToniKH 0AeYMovn (AoiMwSn n aAAn), MeTäoTaon KapKivou, H avTaväKAaon anö evSoKoiAiaKn ßAäßn (iSiwq onio9onepiTovaiKou x^pou). OTav ÖMwq unäpxouv
opioMeva ouMnTWMaTa Kai eupnMaTa,
Yneu8uvoq aAAnAoypa0iac;
Ka8nvnTnQ AäiapoQ I ZaKKäq
PeupaxoAoyiKn KAIVIKH, laTpiKO TpHMa,
ZxoAq EniCTTHM^v YyeiaQ,
naveniCTTHMio QeaaaAiaq
BiönoAiQ 41110, AäpiCTa
TnA +241350 2813, Fax: +2413501016,
email:[email protected]
Corresponding author:
Professor Lazaros I. Sakkas
Department of Rheumatology
Faculty of Medicine, School of Health Sciences,
University of Thessaly and University
General Hospital of Larissa
Biopolis 41110, Larissa
Tel:+241350 2813, Fax:+241350 1016,
email:[email protected]
TOTe unapxei
o o ß a p n unoKeiMevn KaTaoTaon (nivaKaq).
nivaKaq. napdyovTeq KivSuvou yia unoKeiMevn 0Ä£YMovn, KÖrayMa n veonAaoia oe ao8evn Me oo$ua\yia
reviKä CTUMnTWMaTa: nupsTöq, KaTaßoAri OCT^uaAyia nou a^unviZei tov aCT8evr| NeupoAoyiKö ¿AAeiMa
Au^nM^voi öeiKTeq $AeyMovr|Q ctto aiMa(TKE, CRP,
AeuKä, aiMonsTäAia)
MeyäAn nAiKia
iCTTopiKö KapKivou
AvoCTOKaTaCTToAr
H ao9evnq exei oo0uaAYia nou a0unviZei, apa ooßapn unoKeiMevn vöoo, 0AeYMovn, KaTaYMa, n veonAaoia. ^Tnv ao9evn eYive eAeYxoq oTnv aAAn KAiviKn npoq Tnv KaTeu9uvon veonAaoiaq aAAa xwpiq anoTeAeoMa. H MRI Seixvei npooßoAn oÜMaToq onovSüAwv evw
oi MeTa^ü Touq MeooonovSuAioi SioKoi 0aivovTai 0uoioAoYiKoi (EiKÖva). H npooßoAn tou oÜMaToq tou onovSüAou xwpiq npooßoAn tou SioKou eivai unep veonAaoiaq tou onovSüAou (npwTona9n n MeTaoTaTiKH).
To nepiorariKÖ: Neoq epYaoTnpiaKÖq eAeYxoq eSei^e Hct=34%, Hgb=10.6, MCV=67, MCH=21, WBC=11200, P=68%, L=22%, M=7%, E=2%, PLT=418,000 /mL, ESR=71, CRP=6.0 (<0.5 mg/dL). O Aoinöq epYaoTnpiaKÖq eAeYxoq xwpiq eupnMaTa. ZxöAia: H YeviKn aiMaToq eivai ouMßaTn Me eTepöZuYo ß-MeooYeiaKH avaiMia. QoTöoo unapxouv au^nMevoi SeiKTeq 0AeYMovqq (AeuKoKüTTapa, aiMoneTaAia, TKE,
mediterranean journal
of RHEUMATOLOGY
eaahnikh peymatqaoria
26 1
2015
W1274 / C63T TE: 12.520WM577637 TR: 040
Sfioe pes: -28 2 ST: 4 0mm
Srutfy time: 19:02:51
Positon: HFS 5 IMA 6 Zoom factor: xQ 97
EiKova. MRI OMU. (A). T1 aKoAou9ia Seixvei au^nMevo o|Ma Me avoMoioYevn KaiavoMn oto onovSuAo 01 Kai xaMnAo o|Ma Me avoMoioYevn Mop0oAoYia oto onovSuAo 03. (B). T2 aKoAou9ia Seixvei au^nMevo o|Ma Me avoMoioYevn KaiavoMn oto onovSuAo 01 Kai au^nMevo o|Ma Me avoMoioYevn KaiavoMn oto onovSuAo 03.
CRP). Aura eniPePaiwvouv Tnv apxiKn nenoi9non Yia ooPapn unoKeiMevn vooo. ©a ouoi|vaMe Pio^ia Sia PeAovnQ tou naoxovrciQ onovSuAou. To nepiCTiaxiKo: npoYpaMMaTio6nKe Yia Pio^ia onovSuAou MeTa ano 20 nMepeQ eneiSn anouoiaZe o YiaipoQ. TeooepiQ nMepeQ npiv Tnv npoYpaMMaTioMevn Pio^ia, n ao6ev|Q eM0avioe eniAnnTiKeQ KpioeiQ, MRI eYKe0aAou eSei^e xwpoKaTaKTnTiKn PAaPn Se PpeYMaTiKou AoPou, Kai SiaKoMio9nKe oin veupoxeipoupYiKn kaiviki tou NoooKoMeiou MaQ. H
ao9ev|Q eAaPe avTieniAnnTiKi aYWYn Kai unoPA|0nKe oe a0aipeon tou oykou. H na9oAoYoavaToMiKi e^eiaon eSei^e non Hodgkin AeM<t>wMa. ZxoAio: Oo0uaAYia oe ao9ev| Me eva ano touq napaYovieQ KivSuvou tou nivaKa eniPaAAei tov eAeYxo Yia unoKeiMevn vooo. XpeiaZeiai Pio^ia TnQ PAaPnQ tou onovSuAou, eav Sev Ti9eiai n SiaYvwon ano nio npooiTi Qeon Pio^iaQ n aAAn e^eiaon.
