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1.
例1女性,48岁。无明显原因左膝关节疼痛,尚可参加日常劳动。1个月后疼痛加重,行走和活动后疼痛更为明显,关节肿胀,在当地医院理疗2个月后疼痛症状稍有好转。但关节肿胀、活动受限较前逐渐加重。入院手术见关节腔内有白色球状物,呈多面形,表面欠光滑,质地较硬,有光泽,呈灰白色半透明状。送检肿物为圆形或卵圆形,有的呈息肉状,直径0.5-1cm,大小不等,共计18枚,有钙化和骨化散存分布.  相似文献   

2.
目的探讨关节滑膜骨软骨瘤病的影像学表现及鉴别要点。材料与方法回顾性分析15例关节滑膜骨软骨瘤病患者的X线、CT和MRI的影像资料。结果 15例中11例经手术病理证实,4例关节镜证实。X线、CT和MRI均可见游离体形成。游离体体在X线和CT上表现为高密度的钙化小体,圆形或椭圆形,大小不一。小结节影在MR T1WI呈低信号,在T2WI信号不均,钙化部分呈低信号,而未钙化部分呈中等或高信号。CT检查可以发现隐蔽游离体、增厚的滑膜和关节腔积液。MRI能发现关节内未钙化的游离体,除可见关节游离体外,还清晰显示软骨、滑膜、周围软组织的改变和关节积液等表现。结论游离体是滑膜骨软骨瘤病的特征性影像表现,是影像诊断的主要依据,X线诊断简便、快捷,CT、MRI可提供更多的信息。  相似文献   

3.
冯向东  崔涌 《诊断病理学杂志》2005,12(5):355-355,i0006
患者男性,40岁.右大腿包块1月余.查体:右大腿外下方膝关节处有一约7 cm×5 cm×3 cm包块,质地柔韧,边界清,活动度可,膝关节活动尚可,无明显压痛及叩击痛.行包块切除术,见右膝关节髌上囊内有许多结节,质地较硬.  相似文献   

4.
关节滑膜骨软骨瘤病的影像诊断   总被引:1,自引:1,他引:1  
目的:探讨四肢关节滑膜骨软骨瘤病的影像学表现。方法:回顾性分析15例经手术病理证实的四肢关节滑膜骨软骨瘤病,15例均有X线平片检查,其中12例行CT检查,8例行MR检查。结果:15例X线平片均见关节内或/和关节周围大小、数目不一的钙化或骨化游离体;CT和MR显示更清晰、数目更多,较好显示增厚的滑膜、积液及软骨性游离体。结论:X线平片仍是该病的首选检查方法,能显示该病的大部分病灶;CT能发现征象较平片更为丰富,有较高的诊断价值;MR的软组织分辨率高,对滑膜的增厚、积液及软骨性游离体显示较好,但对细小的钙化、骨化的游离体不如CT敏感。  相似文献   

5.
滑膜骨软骨瘤病临床并非少见,多为单关节发病,多关节发病以双膝关节多见,2个关节以上发病目前国内未见报道,我院于2005年6月收治1例,现报告如下。  相似文献   

6.
1病例资料【例1】男,54岁。5个月前骑车下车时突发膝关节疼痛,以后逐渐肿胀,不能活动。经药物保守治疗后肿胀逐渐消退,但疼痛无好转,活动受限。查体:膝关节活动度40°/100°,有明显摩擦音。X线平片示:膝关节软组织轻度肿胀,关节间隙可见2个黄豆大小圆形密度增高阴影,胫、髌骨边缘有骨质增生。予手术治疗,术中发现膝关节滑膜充血、增厚,有绒毛状增生,关节内有3个圆形及桑葚状蚕豆大小游离体,表面为白色软骨组织,质硬;髌骨缘及股骨内外髁部滑膜有多处米粒至黄豆粒大小表面粗糙坚硬肿瘤。手术清除游离体,切除部分滑膜组织及全部肿瘤。术后病理…  相似文献   

7.
滑膜骨软骨瘤病45例影像诊断分析   总被引:1,自引:0,他引:1  
目的探讨滑膜骨软骨瘤病影像学表现。方法回顾性分析45例滑膜骨软骨瘤病患者的X线、CT和MRI的影像资料。结果 X线、CT和MRI均见游离体。游离体在X线和CT上表现高密度的钙化体,圆形或椭圆形,大小不一。MRI图像上游离体为T1WI呈低信号强度,T2WI可见其信号不均,钙化部分呈低信号,而未钙化部分呈中等或高信号强度改变。膝关节、髋关节为最易受累关节,占约75.56%。结论 X线诊断简便、快捷,CT、MRI可提供更多的信息。  相似文献   

8.
目的探讨颞下颌关节髁突滑膜肉瘤的临床特点,以减少误诊误治。方法回顾分析1例颞下颌关节髁突滑膜肉瘤的临床资料。结果本例因左侧耳前区疼痛不适5个月,加重并肿胀半个月就诊。外院诊断为颞下颌关节炎,经相关治疗效果不佳,近期病情加重来我院就诊,经专科查体及CT检查以左侧颞下颌关节肿瘤收入院。行左侧颞下颌关节肿瘤扩大切除术,术后病理及免疫组织化学染色检查确诊为颞下颌关节髁突滑膜肉瘤,行正电子发射计算机体层摄影检查发现胸部及后颈部可疑转移病灶,予放、化疗3个月,复查未见局部复发。结论颞下颌关节髁突滑膜肉瘤临床少见,对可疑骨质破坏者,应进一步行CT及MRI等检查,及早明确诊断并治疗。  相似文献   

9.
10.
1病例资料 女,55岁。因右膝关节疼痛3年,加重伴右膝关节肿胀6个月入院。患者3年前无明显诱因出现右膝关节疼痛,劳动时加重,行走时偶有右膝关节突然交锁,能自行缓解,无症状时右膝关节活动自如,未行任何特殊检查及治疗。  相似文献   

11.
目的探讨影像学对滑膜软骨瘤的诊断价值。方法对经病理及临床综合确诊的19例滑膜骨软骨瘤病的影像学表现进行回顾性分析。结果病变累及膝关节14例,髋关节4例,肩关节1例,影像学表现为关节均有轻度肿胀,关节周围见大小不等的小结节样钙化或骨化影。结论滑膜软骨瘤病的影像学表现具有一定的特征性,结合临床具有较高的诊断价值  相似文献   

12.
Synovial chondromatosis (SC) is a benign condition characterized by the formation of metaplastic cartilage in the synovial membrane of the joint, resulting in numerous attached and unattached osteocartilaginous bodies. SC mostly affects the large synovial joints, especially the knee, hip, elbow, and ankle, whereas involvement of the temporomandibular joint (TMJ) is rare. Approximately 240 cases of SC of the TMJ have been reported in the English-language literature to date. The number of loose bodies varies among patients but usually ranges from the dozens to around 100. We herein report a case of SC of the TMJ accompanied by approximately 400 loose bodies in a healthy 53-year-old woman. Such a high number of loose bodies within a small space is extremely rare. We also include a brief discussion about the differential diagnoses and current diagnostic approaches to SC of the TMJ. Notably, delayed diagnosis or misdiagnosis is common because of the nonspecific nature of the presenting complaints.  相似文献   

13.
关节盘穿孔(disc perforation,DP)是颞下颌关节紊乱病晚期的症状之一,与关节内结构紊乱和髁突骨关节病有密切关系,主要表现为关节区疼痛、张口受限等症状,严重时甚至导致颌面部畸形.症状的相似性和关节的结构复杂性使DP的诊断存在一定的挑战.MRI在临床上广泛用于颞下颌关节成像,可能是一种识别DP简便有效的方法...  相似文献   

14.
This article reviews the imaging anatomy of temporomandibular joint(TMJ), describes the technique of multi-detector computed tomography(MDCT) of the TMJ, and describes in detail various osseous pathologic afflictions affecting the joint. Traumatic injuries affecting the mandibular condyle are most common, followed by joint ankylosis as a sequel to arthritis. The congenital anomalies are less frequent, hemifacial microsomia being the most commonly encountered anomaly involving the TMJ. Neoplastic afflictions of TMJ are distinctly uncommon, osteochondroma being one of the most common lesions. MDCT enables comprehensive evaluation of osseous afflictions of TMJ, and is a valuable tool for surgical planning. Sagittal, coronal and 3D reformatted images well depict osseous TMJ lesions, and their relationship to adjacent structures.  相似文献   

15.
Synovial chondromatosis is a rare, benign, proliferative cartilaginous lesion arising from the synovial tissue, tenosynovium, or bursal lining. We describe the case of a patient who initially presented with multiple axillary masses. Breast ultrasound (US) was requested due to the concern of a breast tumor with axillary lymph node metastases. US study was helpful and provided adequate information to suggest the diagnosis.  相似文献   

16.
This study reviews recent advances in temporomandibular joint (TMJ) or masticatory system related neurology, and suggests the TMJ as a neurological window and lever.The TMJ is integrated with the brainstem centers via the sensorimotor system, including the body balance and coordination control systems. A dysfunctioning TMJ may reflect not only local problems, but also the underlying remote or systemic problems. Neurological examination, including balance testing, for example, may reveal the contributing imbalances and provide an additional evaluation of the appropriateness of TMJ therapeutics being attempted.Repetitive or tonic sensory stimulations involving the TMJ may be related to therapeutic interventions, contributing to neural plasticity, which may be adopted as a therapeutic approach in treatment of neurological disorders, including dystonia and movement disorders.TMJ related therapeutics, such as use of an occlusal splint, cranial manipulation, muscle/myofascial therapy, and acupuncture, ideally need to be practiced along with neurological monitoring, to ensure neurologically desirable effects.  相似文献   

17.
患者女,50岁,因"发现左小腿后内侧肿物1个月、双下肢水肿6个月"就诊.既往类风湿关节炎病史10年,接受口服药物治疗.无重大外伤史.查体:左小腿后内侧可扪及包块,与皮肤及周围组织无明显粘连,无触痛和压痛.双侧足背动脉搏动正常.双膝关节正侧位X线片:双膝关节退行性改变,余未见明确异常.MRI:平扫于双小腿内后方软组织内可见多发不规则囊状长T2异常信号,最大者位于左小腿内侧肌群间(图1);增强扫描见左小腿巨大囊性病变约20.36 cm×4.56 cm×4.21 cm;右小腿囊性病变18.85 cm×3.45 cm×4.81 cm,囊壁明显强化,但厚薄欠均匀,囊内可见分隔,腘窝内见多个大小不一的环状强化病变(图2);双膝关节滑膜增厚及异常强化(图3),滑膜最厚处1.21 cm.  相似文献   

18.
IntroductionThe anatomy and physiology of the temporomandibular joint can be studied clinically and by diagnostic imaging. Magnetic resonance imaging (MRI), radiography (X-ray) and computed tomography (CT) have thus for many years contributed to the study of the kinetics in the mandibular condyle. However, also duplex Doppler ultrasound (US) examination is widely used in the study of structures during movement, particularly vascular structures.Materials and methodsA total of 30 patients were referred by the Department of Orthodontics to the Department of Radiological, Oncological and Pathological Sciences, University of Rome “La Sapienza”. All patients underwent duplex Doppler ultrasound (US) examination of the temporomandibular joint using Toshiba APLIO SSA-770A equipment and duplex Doppler multi-display technique, which allows simultaneous display of US images and color Doppler signals. A linear phased array probe with crystal elements was used operating at a basic frequency of 6 MHz during pulsed Doppler spectral analysis and 7.5 MHz during US imaging.ResultsIn normal patients a regular alternation in the spectral Doppler waveforms was obtained, while in patients with temporomandibular joint meniscus dysfunction there was no regularity in the sum of the Fourier series with an unsteady waveform pattern related to irregular movements of the temporomandibular joint.ConclusionsIn all cases duplex Doppler US examination proved able to differentiate between normal and pathological patients and among the latter this technique permitted identification of the most significant aspects of the dysfunctional diseases.  相似文献   

19.
The purpose of this investigation is to report the technique and assess the utility of ultrasound diagnosis of abscess in the postoperative temporomandibular joint (TMJ). Fourteen patients had 18 ultrasound examinations of the postoperative temporomandibular joint (TMJ) to detect a possible abscess. Ultrasound examinations were performed with either a 5-MHz linear array and/or a 7.5-MHz sector probe following placement of implants (16) and autogenous costochondral grafts (2). The TMJ was scanned in both coronal and axial planes. In 14 examinations, an abscess was not detected; there were no false-negatives. Soft-tissue edema was found in 1 of these 14 examinations; at surgery, there was no abscess. Four examinations were positive for an abscess; 3 of these were confirmed at surgery. One examination was false-positive. We conclude that ultrasonography can detect an abscess in the symptomatic postoperative TMJ. A negative examination is reliable. © 1994 John Wiley & Sons, Inc.  相似文献   

20.
目的探讨膝关节滑膜血管瘤(SHK)的超声表现及其在临床诊断中的应用价值。方法回顾性分析10例经手术及病理确诊为SHK患者的超声声像图表现及临床资料,并与MRI检查结果、手术及病理结果进行对比,对超声检查结果进行分析。结果超声检查诊断提示血管瘤者7例(弥漫型6例、局限型1例),来源于血管的占位1例、髌上囊占位1例、色素沉着绒毛结节性滑膜炎1例,提示血管瘤伴血栓1例、伴骨侵蚀和骨赘形成2例、伴关节腔积液3例。SHK患者的超声声像显示:7例弥漫型肿块二维超声呈边界不清楚、形态不规则、不均匀回声团,5例呈混合回声团、内见管网状无回声,站立位时体积增大,彩色多普勒血流图(CDFI)显示加压试验阳性;1例呈不均匀弱回声团伴多数结节样低回声,CDFI显示加压试验阳性;1例二维超声呈边界不清楚、形态不规则、不均质稍强回声团,加压前后均未见明显血流信号。3例局限型肿块超声表现无特征性。结论弥漫型SHK超声声像图表现具有一定特征性;局限型及伴显著滑膜增生的SHK超声声像图表现无特异性,仅采用超声诊断容易误诊。超声检查不仅能准确评估膝关节囊及周围软组织受累情况,且方便、无创、价廉,可作为弥漫型SHK常规首选无创性检查诊断方法。  相似文献   

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