邻关节骨囊肿一例

邻关节骨囊肿 (骨内腱鞘囊肿 )是局限在关节的软骨下骨内良性囊性病变 ,我院收治 1例 ,报告如下。患者 ,男 ,6 0岁 ,右踝关节疼痛 2年 ,行走时加重 ,休息后缓解 ,1月前疼痛加重 ,呈间歇性隐痛。无明显外伤史。查体 :右踝关节活动正常 ,内踝压痛 ,皮温不高 ,局部无肿胀。Ｘ线片示右内踝有1ｃｍ× 1 5ｃｍ× 1 5ｃｍ大小圆形透光区 ,密度均匀 ,边缘清晰。术前诊断 :右内踝骨囊肿。硬膜外麻醉下手术探查 ,凿开右内踝骨皮质后见有 1ｃｍ× 1ｃｍ× 1 5ｃｍ大小囊腔 ,囊壁呈灰白色 ,内有胶冻样组织 ,周围骨质硬化 ,刮除病变后碘伏冲洗 ,取右髂骨…     

髋臼邻关节骨囊肿的诊断与治疗

目的 探讨髋臼邻关节骨囊肿的诊断、鉴别诊断与治疗方法.方法 回顾性分析1990年8月至2009年4月收治的19例髋臼邻关节骨囊肿患者的I临床资料,男11例,女8例;年龄18～59岁,平均42.3岁.17例有髋关节酸痛不适症状,病程2个月至20年,中位时间为15个月.X线片均显示髋臼负重区近侧椭圆形或圆形溶骨性病变,紧贴软骨下骨,边界清晰,伴有硬化边缘.5例合并髋关节发育不良.刮除病变后予以髂骨植骨14例、异体松质骨颗粒植骨3例、人工骨植骨2例.结果 术前18例确诊,14例依据X线片确诊,4例依据CT和MRI确诊.另1例诊断为单纯性骨囊肿.病灶长径2～4cm者16例,4～8 cm者3例,病灶大小与是否有症状及病程长短无关.17例病灶位于髋臼负重面前上方,2例位于髋臼后上方.全部病例随访11个月至13年,平均6.2年,无囊肿复发.14例无症状,3例偶有髋部不适,2例髋关节发育不良者症状先改善后加重,出现关节间隙狭窄.结论 刮除植骨治疗髋臼邻关节骨囊肿有效,其影像学上病灶分布特点表明病灶发生与应力集中有关.     

邻关节骨囊肿1例

患者姜某，女，52岁。因左足疼痛不适5月，加重2月于2006年7月3日收入院。入院时查体：左足肿胀不明显．压痛不显著。X线片示：左足第2，3楔骨远端及2，3跖骨基底有一偏心性，圆形的低密度改变（见图1），入院时拟诊：左足邻关节骨囊肿。患者入院前5个月，无诱因出现活动后左足痛，渐加剧，经用跌打损伤及消炎止痛药，症状无好转。近两个月酸痛加重，休息后不能缓解，故来诊。入院查体：全身情况好，体温正常，左足皮肤无红肿，皮温不高，浅表静脉无怒张，足背内侧跖骨基底部位轻压痛，足活动正常。     

小儿股骨近端骨囊肿手术治疗16例分析

[目的]探讨小儿股骨近端骨囊肿的手术治疗方法及临床疗效。[方法]2002年3月～2006年3月,共有16例股骨近端骨囊肿的小儿患者接受手术治疗,作者采用囊肿刮除,瘤壁残留肿瘤组织灭活,自体骨、异体骨或骨诱导活性材料植入,根据是否存在病理性骨折及术前分析决定是否采用内固定。[结果]16例患者均获随访,随访时间12～37个月,平均18.5个月。其中13例骨性愈合,愈合时间8～13个月,平均10.2个月。3例复发,再次手术后,恢复良好。[结论]小儿股骨近端骨囊肿的治疗应考虑囊肿大小、侵袭范围以及股骨近端解剖关系,术前分析对是否应用内固定非常重要。骨诱导活性材料（OAM）作为自体骨的替代物,应用安全,疗效可靠。     

腰椎关节突关节滑膜囊肿的诊断和治疗

目的：探讨腰椎关节突关节滑膜囊肿的诊断及治疗方法。方法：对2001～2005年收治的4例腰椎关节突关节滑膜囊肿患者的诊断及治疗进行回顾性分析。术前均行CT检查，其中2例行MRI检查。治疗均采用椎板减压囊肿切除术，术后随访时间为3～6个月。结果：CT及MRI检查可明确诊断腰椎关节突关节滑膜囊肿。4例病人中，3例疼痛症状消失，1例缓解。结论：CT及MRI检查对腰椎关节突关节滑膜囊肿有定性及定位诊断价值，手术治疗效果良好。     

醋酸氢化可的松囊肿内注射治疗手术后复发性骨囊肿

醋酸氢化可的松囊肿内注射治疗手术后复发性骨囊肿梁雨田张伯勋卢世璧作者应用醋酸氢化可的松囊肿内注射治疗２例手术后复发且难于再刮除植骨的骨囊肿，收到了较好的效果。例１男性，８岁。左股骨颈、转子部位骨囊肿，于１９８２年在当地医院行囊肿刮除自家髂骨植骨术，术...     

邻膝关节骨巨细胞瘤外科治疗的选择

目的回顾性分析邻膝关节骨巨细胞瘤外科治疗方法,前瞻性分析骨巨细胞瘤外科治疗方法选择的可行性。方法回顾性分析1978至1997年住院治疗且有完整随访资料的邻膝关节骨巨细胞瘤121例,71例采用病损内手术（刮除,液氮冷冻,自体或异体骨植骨,病损内手术组）,50例采用大块切除异体半关节移植治疗（大块切除重建组）。根据随访患者临床、肿瘤特性及手术方式与肿瘤复发、肢体功能和并发症的相关性研究,按照CT横截面,肿瘤破坏大小,制订新的治疗方案：（1）Ⅰ型肿瘤破坏横轴线1／2以下,病损内手术,灭活,自体、异体骨支撑植骨或骨水泥填充;（2）U型肿瘤破坏横轴线1／2～3／4之间,Ⅰ型治疗基础上加内固定;（3）Ⅲ型肿瘤破坏横轴线〉3／4,大块切除后异体半关节移植或人工关节置换。前瞻性收集1998至2001年住院治疗且有完整随访资料的邻膝关节骨巨细胞瘤65例,其中45例采用病损内手术（刮除,电灼加石炭酸灭活,自体植骨加骨水泥填充,病损内手术组）,20例采用大块切除后人工关节置换（大块切除重建组）,通过患者肿瘤复发、肢体功能和并发症评价该方案的可行性。结果第一时期内,两组间局部肿瘤复发无统计学意义,而病损内手术的术后并发症和肢体功能评分明显好于大块切除重建组。第二时期内,两组间局部肿瘤复发、术后并发症和肢体功能评分无统计学意义,大块切除重建病例数量明显减少。结论邻膝关节骨巨细胞瘤外科治疗,可以根据CT横截面,肿瘤破坏大小,分别选择病损内手术和肿瘤大块切除重建,而有效的病损内手术是邻膝关节骨巨细胞瘤外科治疗的首选。     

关节镜下清理结合关节内引流治疗足踝部腱鞘囊肿的临床分析

目的探讨关节镜下清理关节结合关节内引流治疗足踝部腱鞘囊肿的临床价值。方法于2012年6月至2013年9月,本组共对16例足踝部腱鞘囊肿患者进行关节镜下清理方法切除病变囊壁,并行关节腔打开引流治疗。结果 16例患者获随访6~9个月（平均6.5个月）,总有效率93.8%。术后无并发症,仅1例右足踝腱鞘囊肿术后复发。结论关节镜下切除腱鞘囊肿手术创伤小,并发症少,成功率高,术后恢复快。     

经皮注射微创可注射型硫酸钙人工骨X3联合甲泼尼龙治疗复发性骨囊肿

目的探讨经皮注射微创可注射型硫酸钙人工骨X3（MIIGX3）和甲泼尼龙治疗复发性骨囊肿的疗效。方法2004年1月～2006年3月,对13例经刮除植骨和类固醇注射治疗复发的骨囊肿患儿行经皮注射MIIGX3和甲泼尼龙,X线观察术后囊肿内人工骨降解和新生骨形成情况。结果手术时间30～95min,平均42min。13例术后随访1～3年,无复发,人工骨在术后1.5年完全降解,均被新生骨小梁替代。结论经皮注射MIIGX3和甲泼尼龙治疗复发性骨囊肿创伤小,手术和住院时间短,能提供一定程度力学支撑,疗效满意。     

关节融合术治疗复发性拇趾腱鞘囊肿的临床研究

目的回顾性分析采用腱鞘囊肿切除趾间关节融合术治疗拇趾腱鞘囊肿的疗效。方法笔者自2014-09—2015-03采用囊肿切除趾间关节融合术治疗8例拇趾腱鞘囊肿。结果8例术后随访14~39个月,平均18个月。治疗效果满意,均无囊肿复发。末次随访依据美国足踝关节协会拇趾功能评分标准评定:优7例,良1例,均较术前明显改善。结论腱鞘囊肿切除趾间关节融合术是治疗复发性拇趾腱鞘囊肿的优选方法。     

Intraosseous ganglion cysts

An illustrative case report of intraosseous ganglion cyst is presented. Intraosseous ganglion cysts are uncommon, juxta-articular, and benign. They are thought to arise from an intramedullary metaplastic event. Intraosseous ganglia are most common in middle-aged patients. They usually involve the tibia but also are located in other skeletal sites. The lesion is typically epiphyseal and appears benign. It is successfully treated with curettage and bone graft if it is symptomatic or progressively increasing in size. It is important to avoid extensive surgical procedures. Recurrence is unlikely.     

Juxta-articular myxoma of the wrist: a case report

A 16-year-old boy with a 4-month history of pain and a palpable mass in the right wrist was presented to our clinic. Preoperative diagnosis was a ganglion cyst according to symptoms and physical examination. The lesion was removed by marginal resection and histopathologic examination revealed a juxta-articular myxoma. No recurrence was detected at 1-year follow-up evaluation. We report a case of juxta-articular myxoma of the wrist joint.     

The distribution of bone islands and juxta-articular bone cysts in the growing hand

Bone islands and juxta-articular bone cysts are relatively common incidental findings when X-rays are taken for other purposes. We have identified that the incidence of bone islands in the hands of asymptomatic children between the ages of 5 and 13 years is 3.8% and the incidence of cysts in the same population is 2.8%. Bone islands were most common in the scaphoid, whilst juxta-articular bone cysts were most common in the capitate. The age at which they appear has not been reported previously. This study first identifies their presence in the hands of children of age 10 years and 2 months (bone islands) and 10 years 0 months (juxta-articular bone cysts). Most of the lesions were already present on the first radiograph taken. New bone islands appeared in five cases between the ages of 13 years and 1 month and 15 years and 3 months. New juxta-articular bone cysts were observed to appear in five cases between the ages of 10 years 10 months and 15 years 0 months. No island or cyst changed in size during the review period.     

Acute hemorrhagic cyst of the ligamentum flavum

STUDY DESIGN: A case report and clinical discussion. OBJECTIVE: To describe a rare complication of a cyst of the ligamentum flavum, which bled spontaneously, provoking an acute lower limb monoparesis and lumbar sciatic pain. SUMMARY OF BACKGROUNDS DATA: Cysts of the ligamentum flavum have been rarely reported. Intraspinal degenerative cysts described in literature are usually juxta-articular (synovial and ganglion) cysts and have a similar radiologic appearance. They are preferentially located in the lumbar spine, while the cervical localization is unusual. Hemorrhage into the cyst is an uncommon complication and an extremely rare cause of nerve root compression. METHODS: A 59-year-old woman presented with sudden severe radicular lumbar deficit and pain secondary to acute hemorrhage into a ligamentum flavum cyst. Magnetic resonance imaging showed at L3-L4 level a lobulated slightly hyperintense mass with a ventral area of marked hyperintensity in T1 images, hypointense on T2 images. Signal within the lesion was suggestive of intralesional hemorrhage. RESULTS: Complete resection of the lesion was performed, resulting in immediate recovery. The cyst was quite rounded, brownish, and contained rest of both partially fresh and coagulated hematoma. Histologic examination revealed myxoid degeneration of the ligamentum flavum with an hemorrage in the cystic cavity without a synovial layer. CONCLUSIONS: This report identifies a rare case of radicular lumbar deficit and pain secondary to acute hemorrhage into a ligamentum flavum cyst. The pathogenesis and clinicopathologic characteristics of this lesion are described.     

Local arthroscopic bone grafting of a juxta-articular glenoid bone cyst

This report describes a rare, juxta-articular bone cyst of the posterior glenoid that developed after a fracture of the glenoid in a 38-year-old male. The patient had persistent pain, popping and stiffness of his right shoulder for 3 years, and failed to improve after a nonoperative rehabilitation program. At arthroscopy, the senior author transported an autogenous bone graft from the bare area of the humeral head to fill the glenoid cyst arthroscopically. At second-look arthroscopy approximately 1 year after the index procedure, the bone graft had consolidated within the original cystic defect and the surface was covered with fibrocartilage. The graft harvest site posteriorly on the humeral head had healed with a small amount of scar tissue at the articular margin. Comfortable motion and function were restored.     

Ganglion cysts of the cruciate ligaments: a series of 31 cases and review of the literature

ABSTRACT: BACKGROUND: A case series for ganglion cyst of the cruciate ligament with MRI findings, clinical presentation, and management options along with review of literature is presented. METHODS: Of 8663 consecutive patients referred for knee MR imaging, 31 were diagnosed with ganglion cysts of the cruciate ligaments, including 21 men and 10 women of ages 12 to 73 years (mean: 37). A review of charts revealed that knee pain was the chief complaint in all cases. Arthroscopic debridement of ganglion cyst was performed in 11 patients. RESULTS: MRI proved to be a valuable tool in diagnosing and deciding management of these cases. All 11 patients who underwent arthroscopic treatment were symptom-free on a minimum follow-of one year. CONCLUSION: Cyst formation associated with cruciate ligament of the knee is an infrequent cause of knee pain. MR imaging was important in confirming the cyst lesions and provided useful information prior to arthroscopy. Arthroscopic debridement of ganglion cyst produced excellent outcome without recurrence. This study describes the pertinent MRI and intraoperative findings of ganglion cyst.     

99mTc]diphosphonate uptake and hemodynamics in experimental arthritis: effect of naproxen in the canine carrageenan injection model.

The impact of naproxen treatment on juxta-articular hemodynamics and bone metabolism in experimental juvenile arthritis was studied in the articular carrageenan injection model. Unilateral gonarthritis was induced for 12 weeks in eight dogs receiving naproxen (dosage, 2 mg/kg) and eight controls. Regional blood flow was assessed by the microsphere method, plasma volume by the distribution space of [125I]fibrinogen, and bone metabolism by the 2-h uptake of [99mTc]diphosphonate ([99mTc]DPD). Synovial effusion was less prominent with naproxen treatment as judged by joint fluid volume and pressure. Naproxen reduced the arthritic capsular hyperemia, almost normalized a severe blood flow increase in patella and both juxta-articular epiphyses, ameliorated an expansion of plasma volume in the patella and the distal femoral epiphysis, and normalized an increased [99mTc]DPD uptake in subchondral femoral bone and the tibial cortex. Significantly increased arteriovenous shunting in the arthritic extremity was unaffected by naproxen. The study suggests that long-term cyclooxygenase inhibition offers protection against hemodynamic and metabolic changes in juxta-articular bone secondary to synovial inflammation.     

Intraosseous ganglion cyst of the lunate: diagnosis and management.

Intraosseous ganglion cyst of the lunate is an uncommon lesion and cause of wrist pain. Histopathologically it is identical to the common dorsal wrist ganglion and treatment by arthrotomy, curettage of the ganglion and bone graft resulted in clinical improvement in nine patients, six of whom became symptom-free.     

Intra-articular ganglion cysts of the cruciate ligaments: case report and review of the literature

BACKGROUND: A ganglion can arise as a cystic lesion from a tendon sheath or a joint capsule and contain a glassy, clear, and jelly-like fluid. They can occur within muscles, menisci, and tendons. Intra-articular ganglion cysts of the knee joint are rare. We report on three ganglion cysts of the cruciate ligaments: Two were intercruciate, and one was located around the posterior cruciate ligament. METHODS: The clinical diagnosis was established using magnetic resonance imaging. All patients were treated successfully using arthroscopic debridement by basket punch and shaver. Subsequent histological examination confirmed the diagnosis. RESULTS: All three patients were asymptomatic at the postoperative follow-up of 16-36 months. CONCLUSION: A review of the literature reveals a controversial discussion about the clinical significance as well as the etiology of ganglion cysts arising from the cruciate ligaments. These case reports show that an intra-articular ganglion cyst of the cruciate ligaments is difficult to diagnose. A cyst does not necessarily have to be associated with specific clinical symptoms or a previous trauma. Preoperatively, MRI is essential when diagnosing ganglion cysts of the knee joint. An intra-articular ganglion cyst of the knee joint can be successfully treated by arthroscopy.