滑膜骨软骨瘤病的CT诊断

目的 分析滑膜骨软骨瘤病的X线、CT表现,讨论本病的CT诊断价值。方法 11例经手术病理证实的滑膜骨软骨瘤病患者均行CT扫描,其中8例摄X线平片。结果 X线正确诊断6例,CT正确诊断10例。11例CT扫描均见钙化或骨化的游离体与悬垂体,以及关节内不同程度积液,9例见滑膜增厚并呈局部绒毛状或结节状隆起。游离体与悬垂体形态多样,呈均匀或不均匀钙化,数目从几枚到上百枚。结论 CT可以明确诊断该病,能发现X线平片不能发现的征象,具有较高的诊断价值。     

滑膜骨软骨瘤病的X线诊断(附84例分析)

目的:探讨滑膜骨软骨瘤病的X线诊断特点,提高对本病的诊断水平。方法:对经病理及临床综合确诊的84例滑膜骨软骨瘤病的X线表现进行回顾性分析。结果:本组84例中,踝关节3例,膝关节47例,髋关节11例,肘关节9例,肩关节14例,关节内均表现为多个圆形或卵圆形密度增高的钙化或骨化结节影,大小不一、数目不等。结论:滑膜骨软骨瘤病的X线表现具有一定特征性,结合临床具有较高诊断价值。     

膝关节滑膜骨软骨瘤病的影像学诊断价值

目的探讨X线、CT、MRI诊断膝关节滑膜骨软骨瘤病的价值。方法回顾分析16例经关节内镜或手术病理证实的膝关节滑膜骨软骨瘤病影像学资料,总结分析X线平片(DR)、CT和MRI表现特征。结果 16例(18个膝关节)中12例(14个膝关节)(14/18,77.7%)X线表现为膝关节周围见多枚不规则钙化或骨化结节影,另4例仅见关节软组织肿胀而未见骨化钙化影,其中10例典型者呈多发成簇的"石榴籽"样或"同心圆"状。CT能清晰显示的软骨瘤游离体结构、大小、位置、数目,尤其对软骨体内微细钙化较平片更为敏感,同时在观察软骨小体在关节滑囊内或囊周的分布也明显优于DR。16例中14例(16个膝关节)(16/18,88.8%)膝关节周围见多枚不规则钙化或骨化结节影, MPR及VR可以多方位显示钙化及骨化的游离体。16例(18个膝关节)MRI均表现为滑膜弥漫性或局限性增厚,不同程度关节积液。增厚滑膜T_1WI呈等或稍低信号、T_2WI呈高信号。本组14例(16个膝关节)见游离体,2例仅表现为滑膜增厚,关节游离体分布部位:髌上囊区8例、关节腔内5例、腘窝区2例、髌下脂肪垫区1例、全膝关节2例。结论膝关节滑膜软骨瘤病具有以下特点:滑膜弥漫性或局限性增厚、关节游离体、关节腔积液、无关节骨质破坏。X线、CT、MRI对诊断膝关节滑膜骨软骨瘤病各有优势。X线和CT发现钙化与骨化占优势,MRI发现仅表现为滑膜增厚的早期病变有独特优势。     

原发性滑膜骨软骨瘤病的影像诊断

目的分析原发性滑膜骨软骨瘤病的X线、CT和MRI表现。方法22例原发性滑膜骨软骨瘤病患者均行CT扫描,其中16例拍摄X线平片,2例做MRI检查。结果22例中男13例,女9例。20例为单关节发病,2例为双侧关节同时发病。20例表现为关节内或周围大小不一、数目不等的结节状钙化或骨化影,1例表现为髋关节内分叶状软组织块影伴有钙化,并有髋臼骨质破坏,另1例表现为膝关节内条状软组织密度伴有点状钙化。2例关节骨质破坏,手术证实为软骨结节压迫所致。结论X线平片和CT扫描能够显示钙化或骨化的软骨结节,对未钙化或骨化的软骨结节MRI能够清楚显示。     

滑膜软骨瘤病X线征象分析

目的：探讨本病的X线征象及其诊断价值。方法：回顾性分析经手术病理证实的80例滑膜骨软骨瘤病的临床及X线表现。结果：病变累及膝关节52例，肩关节12例，髋关节8例，肘关节6例，踝关节2例，双侧膝关节对称性发现7例。X线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：根据病变游离体发生部位可分囊内和囊外型。囊外型不出现关节退行性改变。囊内型通常表现有关节退行性改变和关节内游离体多发游离体钙化具有重要诊断价值。     

滑膜软骨瘤病的影像学表现

目的 探讨滑膜软骨瘤的影像学特征.方法 回顾分析63 例经手术病理证实的滑膜软骨瘤影像学资料,总结其X线平片(63例)、CT(12例)和MRI(18例)表现特征.结果 63例中发生在膝关节46例,髋关节12例,肘关节3例,踝关节1例,肩关节1例.X线平片显示59例关节周围软组织内多发且数量不等的结节状或不规则钙化骨化影,4例仅见关节软组织肿胀而未见钙化骨化影.CT均可见较平片更为清晰的多发的钙化骨化结节影及滑膜增厚.MRI均显示关节滑膜增厚及结节样隆起,并见1个或多个不同成分特征及信号强度的软骨小体.结论 滑膜软骨瘤病在X线平片、CT 和MRI 表现具有特征性,特别是MRI能发现病变早期未钙化的软骨小体,使该病在早期能作出正确诊断,同时MRI能对该病进行较准确的分型.     

膝关节滑膜骨软骨瘤病的临床X线表现(附6例报告)

滑膜骨软骨瘤是一种较少见的关节疾病,系滑膜良性肿瘤。我院分析2001~2004年收集的膝关节滑膜骨软骨瘤病的临床X线表现,报告如下。1材料与方法本组6例中,男5例,女1例。其中4例为单侧发病,2例为双侧发病,无外伤史。使用F78-Ⅱ型300mA X光机,投照条件:100mA,50kV。6例均作膝关节正侧位片,并根据其X线表现结合临床资料及病理证实。2结果本组5例膝关节内及关节周围见多数圆形或卵圆形结节状钙化或骨化影。直径2mm~2cm不等,密度均匀。1例关节内未见明显钙化或骨化征象(图2)。3讨论滑膜骨软骨瘤病大多起源于关节的滑膜,也起自滑囊和腱鞘的滑膜[…     

滑膜软骨瘤病影像学诊断

目的 探讨滑膜软骨瘤病的影像表现及诊断价值.方法 回顾性分析36例经手术病理证实的滑膜软骨瘤病.36例均行相应关节X线检查,其中13例行CT检查,10例行MR检查.结果 36例滑膜软骨瘤病患者中膝关节22例,髋关节5例,踝关节3例,肩关节2例,肘关节2例,腕关节及颞颌关节各1例;单关节发病31例,双关节发病5例均为膝关节.X线及CT表现为关节间隙及周围有钙化的骨小体,少的1个,多的达数百个,小如米粒,大的直径达2.7 cm.10例MRI检查中,8例钙化结节表现为T_1WI及T_2WI呈低信号,2例钙化结节中心T_1WI及T_2WI呈高信号,周边呈低信号.结论 X线、CT及MRI对本病诊断有重要作用.     

膝关节滑膜骨软骨瘤病X线诊断(附38例分析)

滑膜骨软骨瘤病是一种较少见的关节疾病，系滑膜良性肿瘤，是关节滑膜化生、滑膜内软骨或骨软骨结节形成关节游离体的慢性关节病。本文重点分析我院2004～2008年收集的膝关节滑膜骨软骨瘤病的X线表现。以探讨本病的病因及鉴别诊断。     

滑膜骨软骨瘤病的x线和CT表现

滑膜骨软骨瘤病起源于滑膜下层的结缔组织病变,关节滑膜软骨性化生,在滑膜面下形成多发的软骨性结节,突向关节腔内,这些软骨体结节可以游离于关节腔内,由关节滑液供给营养,并可钙化或骨化。本病较少见,主要表现为关节疼痛、肿胀、活动受限。X线平片结合CT检查可以大大提高该病诊断的准确率。本研究对我院手术和病理证实的10例滑膜骨软骨瘤病患者临床资料进行回顾性分析,现报告如下。     

Primary synovial osteochondromatosis of the first metatarsophalangeal joint

Synovial osteochondromatosis is an uncommon disorder, generally seen in large joints such as the knee, elbow, shoulder, hip and ankle. We report a 35-year-old man with synovial osteochondromatosis of the metatarsophalangeal joint of the great toe. Despite the rarity of the location, the radiographic appearance ought to suggest the diagnosis. Histological confirmation is required, since malignancy cannot be totally ruled out clinically and radiographically.     

Multiple loose bodies in rheumatioid arthritis

Intra-articular loose bodies are usually secondary to osteochondral fractures, osteochondritis dissecans, synovial osteochondromatosis, and degenerative arthritis. The authors report four patients with longstanding rheumatoid arthritis and multiple loose bodies in a variety of joints. All patients have remained active despite their disease, suggesting that the loose body production was secondary to trauma of continued activity superimposed on joints containing pannus and eroded cartilage.     

Synovial osteochondromatosis in hereditary arthro-ophthalmopathy (Wagner-Stickler syndrome)

A case of bilateral synovial osteochondromatosis in a patient with hereditary arthro-ophthalmopathy is presented. The osteochondral lesions were largely calcified in one joint and largely chondromatous in the other. Typical features of hereditary arthro-ophthalmopathy are reviewed and it is hypothesised that the abnormal collagen in this syndrome is responsible for the development of synovial osteochondromatosis. Synovial manifestations of skeletal dysplasias have to our knowledge not been described previously but we suggest that synovial osteochondromatosis can be the manifestation of an underlying skeletal dysplasia.     

Primary synovial osteochondromatosis of the hip: extracapsular patterns of spread

Objective To identify patterns of extracapsular extension of synovial osteochondromatosis of the hip.Design and patients Seven cases of synovial osteochondromatosis of the hip were retrospectively reviewed. Imaging performed included conventional radiography (n=7), arthrography (n=1), CT (n=3) and MR imaging (n=3). Disease extent on imaging was assessed for each patient and the presence of intra-articular effusion, capsular abnormality and osteochondral bodies recorded. The presence and distribution of extra-articular spread was also assessed and correlated with the surgical findings. In all cases diagnosis was confirmed by biopsy, with all patients undergoing tumor resection with or without synovectomy.Results In five cases (5/7) disease extended beyond the hip capsule, while the remaining two cases (2/7) were confined to the hip joint. These findings were confirmed at surgery. Two distinct patterns of extracapsular spread were identified. The first pattern, noted in three cases, involved tumor extension along iliopsoas. The second pattern, noted in five cases, involved tumor extension along the obturator externus fat plane. In three cases both patterns were present.Conclusions Extra-articular spread of synovial osteochondromatosis is common. Patterns of extra-articular spread may be predictable based on involvement of recognized periarticular bursae of the hip joint. Bursal patterns of extra-articular spread include extension into the iliopsoas bursa as well as communication along the obturator externus bursa of the hip.     

Magnetic resonance appearance of intra-articular synovial sarcoma: case reports and review of the literature

Intra-articular synovial sarcoma is extremely rare. The authors report the magnetic resonance appearance of 2 cases of intra-articular synovial sarcoma and review the current medical literature on this subject. Intra-articular synovial sarcoma must be considered in the differential diagnosis of a heterogeneously enhancing multiloculated intra-articular mass, especially in the knee joint, that does not have the typical radiological features of either synovial osteochondromatosis, pigmented villonodular synovitis, or synovial hemangiomas.     

Synovial osteochondromatosis of the shoulder: MR findings

A case of bilateral shoulder synovial osteochondromatosis demonstrated by magnetic resonance (MR) is presented. Shoulder involvement by synovial osteochondromatosis is unusual, and this case demonstrates the characteristic MR findings.     

Synovial osteochondromatosis presenting as a mass in the buttock.

A 42-year-old woman, who had received a radiologic diagnosis of synovial osteochondromatosis many years before, was examined for a painful right hip and a large immobile mass in the right buttock. Findings of radiologic and scintigraphic imaging were consistent with synovial osteochondromatosis. The patient underwent arthrotomy and excision of the large mass and several smaller masses to control pain and to identify possible malignant change.