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以腘窝囊肿为表现的色素沉着绒毛结节性滑膜炎1例

2017-11-26 佚名 临床骨科杂志

腘窝囊肿色素沉着滑膜炎
关注

患者，女，51岁，无意中发现右膝后方包块3年余，一直未予以重视，包块渐增大至鸡蛋大小，行走时轻度肿胀感，于2016年4月来我院就诊。

【一般资料】

患者，女，51岁，

【现病史】

无意中发现右膝后方包块3年余，一直未予以重视，包块渐增大至鸡蛋大小，行走时轻度肿胀感，于2016年4月来我院就诊。

【体格检查】

右膝关节无肿胀，皮温不高，右膝关节后内侧可触及一约4.0CM×4.0CM包块，边缘欠清晰，质韧，压痛(+/－)，浮髌实验(－)，右膝关节屈伸活动尚可

【辅助检查】

右膝关节X线片:骨质未见明显异常，关节间隙正常。右膝关节MRI(见图1):腘窝内可见多个囊性长T2信号，其间可见分割；内外侧副韧带、半月板及前后交叉韧带未见异常信号；膝关节后方可见囊状长T2液体信号；关节腔可见结节状等T1、短T2信号，边缘欠清晰。



【初步诊断】

右腘窝囊肿。

【治疗】

在硬膜外麻醉下手术，取右膝关节后方弧形切口，见包块位于腓肠肌内侧头与半膜肌之间，有完整包膜，沿包块周围钝性分离直至根部，见其底部与股骨内髁相连，与关节腔相通，予以完整切除，见包膜内黄褐色液体。稀碘水冲洗创腔，查无活动性出血，逐层缝合切口。切除的标本送病理组织检查，术后病理诊断为色素沉着绒毛结节性滑膜炎(见图2)。

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    2018-09-20 crystal0572

    #结节性#

    0

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    2018-07-15 sunylz

    #色素#

    0

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    2017-11-30 明天会更好！

    学习了.谢谢分享!

    0

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    2017-11-30 明天会更好！

    学习了.谢谢分享!

    0

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    2017-11-28 12498ca5m83暂无昵称

    #囊肿#

    0

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    2017-11-28 pcw106

    #滑膜炎#

    0

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    2017-11-26 暂20a6e63m

    挺好的呀

    0

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    2017-11-26 戒馋，懒，贪

    谢谢分享学习了

    0