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Anales de Radiología México 2011;4:214-224.

ARTÍCULO DE REVISIÓN

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HQFDPDFDORUORFDO\DQWLLQÀDPDWRULRV LPiJHQHVD *HQHUDOPHQWHSURGXFHDOWHUDFLRQHVUDGLROyJLFDVD
\E 'HDGHORVFDVRVSXHGHQHYROXFLRQDU ORVRPHVHVGHHYROXFLyQTXHFRQVLVWHQHQ
DRVWHRQHFURVLVFRPRODHQIHUPHGDGGH/HJJ&DOYH
3HUWKHV (/&3  6HGHEHUHFRUGDUTXHH[LVWHQ ‡ $XPHQWR GH OD GLVWDQFLD DUWLFXODU GH OD FDEH]D
GRVIRUPDVGHSUHVHQWDFLyQGHOD(/&3ODSRWHQFLDO IHPRUDO\HODFHWiEXOR
\ OD YHUGDGHUD (Q OD IRUPD SRWHQFLDO HO HVWUpV \ HO ‡ 'LVPLQXFLyQGHOWDPDxRGHHSt¿VLVFRQDXPHQWR
FL]DOODPLHQWR QR VRQ OR VX¿FLHQWHPHQWH IXHUWHV SDUD HQODGHQVLGDG
FDXVDU OD IUDFWXUD GHO KXHVR VXEFRQGUDO GHELOLWDGR ‡ )UDFWXUDVXEFRQGUDOGHODFDEH]DIHPRUDO VLJQRGH
SRUODLVTXHPLDHQODIRUPDYHUGDGHUDRFXUUHWRGROR *DJHLPiJHQHVDEF\G 
FRQWUDULR 'H KHFKR OD IRUPD SRWHQFLDO FDXVD SRFRV ‡ /RVKDOOD]JRVWDUGtRVVHPDQL¿HVWDQFRPRIUDJ-
RQLQJ~QVtQWRPD\HVWRODFRQYLHUWHHQODIRUPDPiV PHQWDFLyQ GH OD FDEH]D TXLVWHV VXEFRQGUDOHV

Octubre-Diciembre 2011 219


A B

& D

Imágenes 7a, 7b, 7c, 7d y 7e. 5DGLRJUDItDV GH SHOYLV HQ


SRVLFLyQQHXWUD\DEGXFFLyQIRU]DGD0XHVWUDQGLVFUHWRDX-
PHQWRGHYROXPHQHQSDUWHVEODQGDVGHODFDGHUDL]TXLHUGD
QRVHLGHQWL¿FDQIUDFWXUDV(OHVWXGLRGHXOWUDVRQLGRPXHVWUD
LUUHJXODULGDGFRQDXPHQWRGHODHFRJHQLFLGDG\GLVFRQWLQXLGDG
FRUWLFDOSRUIUDFWXUDGHOODEUXPVXSHULRU

2 2 0 Octubre-Diciembre 2011
A B

& D

Imagen 8.5DGLRJUDItDGHSHOYLV(a)TXHPXHVWUDDVLPHWUtDGHORVWHMLGRVEODQGRVFRQDXPHQWRGHYROXPHQHQHOODGRL]-
TXLHUGR/DVLPiJHQHVGHXOWUDVRQLGR(b) y (c)PXHVWUDQDXPHQWRGHOOtTXLGRLQWUDDUWLFXODUDVtFRPRHQORVWHMLGRVEODQGRV
DG\DFHQWHV/DJDPPDJUDItDyVHDPXHVWUDLQFUHPHQWRGHFDSWDFLyQGHOUDGLRIiUPDFRHQODFDGHUDFRQ¿UPDQGRHOGLDJQyVWLFR
GHVLQRYLWLV(d)

HQVDQFKDPLHQWRGHOFXHOOR\OX[DFLyQODWHUDOGHO Sarcoma de Ewing


IpPXU LPDJHQ  2WUDV HWLRORJtDV TXH SXHGHQ PDQLIHVWDUVH FRQ
(VWXGLRVGHJDPPDJUDItDSUHVHQWDQKDELWXDOPHQWH FODXGLFDFLyQ\PROHVWLDVSDUDODPDUFKDLQFOX\HQODV
GLVPLQXFLyQHQODFDSWDFLyQ OHVLRQHVWXPRUDOHVHQWUHRWURVHOVDUFRPDGH(ZLQJ
TXHSXHGHQLQFOXVRFRQIXQGLUVHFRQRVWHRVDUFRPDR
(SL¿VLROLVWHVLVGHODFDEH]DIHPRUDO OHVLyQPHWDVWiVLFD6XHOHSUHVHQWDUVHFRPRXQWXPRU
6HSUHVHQWDJHQHUDOPHQWHHQDGROHVFHQWHVREHVRV SpOYLFRRFRPRDIHFWDFLyQDODPHWi¿VLVSUR[LPDOGHO
/RVVtQWRPDVVRQGRORUGHFDGHUDJO~WHRRURGLOOD6H IHPXU LPiJHQHVDEF\G 
GHEH D XQ GHVSOD]DPLHQWR HSL¿VLRPHWD¿VLDULR DEDMR
DWUiV\SXHGHWHQHUXQDSUHVHQWDFLyQDJXGDHQFDVRGH Enfermedad de Osgood Schlater
WUDXPDWLVPR7LHQHFXUVRFUyQLFROLJDGRDDIHFFLyQGHO (VXQSURFHVRFRP~QHQQLxRVGHORVDxRVKDVWD
FDUWtODJRGHFUHFLPLHQWR(QGHORVFDVRVVHSUHVHQWD ORVDGROHVFHQWHVGHSRUWLVWDVVHSUHVHQWDQFRQGRORU
FRQDFRUWDPLHQWRGHODH[WUHPLGDGFRQURWDFLyQH[WHUQD VHOHFWLYRVREUHODWXEHURVLGDGDQWHULRUGHODWLELD6H
GHOSLHHOGLDJQyVWLFRVHUHDOL]DFRQUDGLRJUDItDVSHURHO SURGXFHSRUPLFURWUDXPDWLVPRVVREUHHOFDUWtODJRGH
XOWUDVRQLGRWDPELpQSHUPLWHLGHQWL¿FDUORVFDPELRVPtQL- FUHFLPLHQWR/RVVtQWRPDVFHGHQFXDQGRODWXEHURVLGDG
PRVGHGHVSOD]DPLHQWR LPiJHQHVDE\F  WLELDOVHIXVLRQDKDFLDORVDxRV0HMRUDWDPELpQ

Octubre-Diciembre 2011 221


A B

Imagen 9.8OWUDVRQLGRHQLPDJHQWUDQVYHUVDOTXHPXHVWUDODDIHFWDFLyQDORVWHMLGRVEODQGRVSDWUyQKHWHURJpQHRSRUSURFHVR
LQÀDPDWRULRFRQLQYROXFUDPLHQWRLQWUDDUWLFXODU(a)(QODLPDJHQORQJLWXGLQDOVHLGHQWL¿FDODDIHFFLyQLQWUDDUWLFXODU\yVHDFRQ
FDPELRVGLVFUHWRVGHLUUHJXODULGDGHQODFRUWLFDOGHODFDEH]DIHPRUDO(b)

A B

& D

Imagen 10.,PDJHQUDGLROyJLFDGHSHOYLVFRQFDPELRVGHLUUHJXODULGDGHQODVXSHU¿FLHGHODFDEH]DIHPRUDOL]TXLHUGD(a)
/DVLPiJHQHVGHXOWUDVRQLGR(b)(c) y (d)PXHVWUDQPHMRUODLUUHJXODULGDG\GHIRUPLGDGGHODFDEH]DIHPRUDOLQFOXVRFRQ
DIHFFLyQDWHMLGRVEODQGRV

2 2 2 Octubre-Diciembre 2011
DOGLVPLQXLUODDFWLYLGDGGHSRUWLYD LPiJHQHVDE
\F 
2WUDVOHVLRQHVTXHVHSUHVHQWDQHQODFDGHUDRHQ
OD H[WUHPLGDG LQIHULRU TXH VH PDQL¿HVWDQ FRQ GRORU
UHIHULGR D OD FDGHUD \ PDUFKD FODXGLFDQWH LQFOX\HQ
WUDXPDWLVPR \ OHVLRQHV URWXOLDQDV KHPDWRPDV \ RV-
WHRQHFURVLVGHORVKXHVRVGHOSLHHQWUHRWUDV

Conclusiones
(O XOWUDVRQLGR HQ HO QLxR FRQ FODXGLFDFLyQ SXHGH
UHDOL]DUVHFRPRPpWRGRGHHVWXGLRLQLFLDOVREUHWRGR
DQWHODVRVSHFKDGHGRORUHQFDGHUD$\XGDDHVWDEOH-
FHUXQGLDJQyVWLFRSDUDODVROLFLWXGGHRWURVHVWXGLRV
FRQYHQLHQWHV\HVSHFt¿FRVSDUDGHWHUPLQDUODVFDXVDV
GHODHQIHUPHGDG\SHUPLWHHOVHJXLPLHQWR\HYROX-
FLyQGHDIHFFLRQHVFRPRODGLVSODVLDGHFDGHUDRORV
SURFHVRVLQÀDPDWRULRV6LUYHDVXYH]FRPRPpWRGR
GHGLDJQyVWLFRPHGLDQWHELRSVLDRGHWUDWDPLHQWRFRQ
DVSLUDFLyQGHFRQWHQLGROtTXLGRRKHPiWLFRHQDOJXQDV
GHODVOHVLRQHVPHQFLRQDGDV$GHPiVFDEHGHVWDFDU
Imagen 11.5DGLRJUDItDGHSHOYLVFRQFDPELRVFUyQLFRVGH VXYHUVDWLOLGDGGLQDPLVPRQRVHGDFLyQGHOSDFLHQWH
HQIHUPHGDGGH/HJJ&DOYH3HUWKHVELODWHUDO\FR[DYDUD \EDMRFRVWRHQWUHRWURV

A B &

Imagen 12.6HLGHQWL¿FDQODVSRVLFLRQHVYDULDQWHVHQTXHVHGHEHYDORUDUODFDEH]DIHPRUDODQWHVRVSHFKDGHGHVSOD]D-
PLHQWR(a)/DVLPiJHQHVGHXOWUDVRQLGRSHUPLWHQYDORUDUGHPDQHUDFRPSDUDWLYDODSRVLFLyQGHODVFDEH]DVIHPRUDOHV\
GHWHUPLQDUHOGHVSOD]DPLHQWRGHODVPLVPDVD~QHQHWDSDLQLFLDO(b) y (c)/DLPDJHQUDGLRJUi¿FDHQHWDSD\DHVWDEOHFLGD
GH¿QHODOX[DFLyQSRUGHVOL]DPLHQWRGHODFDEH]DIHPRUDO

A B & D

Imagen 13.,PDJHQUDGLROyJLFDTXHPXHVWUDLUUHJXODULGDGHQODGHQVLGDGGHODUDPDLOLRS~ELFDGHUHFKDFRQ]RQDVUDGLR-
O~FLGDV\UHDFFLyQSHULyVWLFD(a)(OXOWUDVRQLGR(b)PXHVWUDHODXPHQWRGHYROXPHQGHORVWHMLGRVEODQGRV\ODLUUHJXODULGDG
FRUWLFDO/DWRPRJUDItDFRPSXWDGD(c)GH¿QHPHMRUODGHVWUXFFLyQyVHDPLHQWUDVTXHODUHVRQDQFLDPDJQpWLFD(d)FDUDFWHUL]D
ODDIHFWDFLyQyVHD\GHORVWHMLGRVEODQGRV

Octubre-Diciembre 2011 223


A B &

Imagen 14.)RWRJUDItD(a)TXHPXHVWUDDXPHQWRGHYROXPHQHQORVWHMLGRVEODQGRVDQLYHOGHO
WXEpUFXORWLELDODQWHULRU(OXOWUDVRQLGR(b)PXHVWUDLUUHJXODULGDGGHODFRUWLFDODQLYHOGHOWXEpU-
FXORFRQDXPHQWRGHYROXPHQGHORVWHMLGRVEODQGRV/DUDGLRJUDItD(c)PXHVWUDODDYXOVLyQ
GHOWXEpUFXOR

Referencias
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)DFXOWDG GH &LHQFLDV 0pGLFDV 0DQXHO $JUDPRQWH3LxDv FRVWDUULF>RQOLQH@
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2 2 4 Octubre-Diciembre 2011

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