滑膜骨软骨瘤病的影像诊断价值

目的 探讨影像检查对滑膜骨软骨瘤病的诊断价值.方法 回顾分析临床手术或关节镜病理确诊的滑膜骨软骨瘤病39例,分析其影像表现及其诊断价值.结果 发病关节为膝关节11例,髋关节10例,踝关节7例,肩关节8例,肘关节3例(其中5例多关节发病). X线表现主要见关节内或关节旁大小不等,形态不一,数目多少不等的游离钙化或骨化影;CT(25例)表现见比X线平片更清晰的关节内或关节旁游离钙化或骨化影,并可显示增厚的滑膜和关节积液;MRI(30例)能发现关节内未钙化软骨瘤结节,除可见关节游离体,还清晰显示软骨、滑膜、周围软组织的改变情况和关节积液等表现,并可作出分期诊断.结论 影像学检查对滑膜骨软骨瘤病有较高的诊断价值,同时对制订手术方案等方面有较高的临床应用价值.     

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。     

原发性滑膜骨软骨瘤病（附25例报告）

目的：探讨原发性滑膜骨软骨瘤病影像表现及诊断价值。方法：25例经手术病理证实的原发性滑膜骨软骨瘤病的影像表现进行回顾性分析。结果：①25例均有不同程度的关节软组织肿胀。②关节囊或其邻近的黏液囊内大小不一，数目不定的骨软骨体，典型表现为中心密度较淡，而周边部围绕着致密环。③骨软骨体可对邻近骨造成压迫性骨吸收破坏。结论：X线平片仍是诊断本病的主要手段，如与MR及B超相结合，则有助于本病的早期诊断。     

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。     

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[…     

滑膜骨软骨瘤病的X线诊断(附21例报告)

滑膜骨软骨瘤病是一种比较少见的慢性关节疾患。X线检查以关节腔内钙化或骨化的软骨结节为其主要特征。本文报告21例,着重分析其X线表现。 临床资料 21例中最小17岁,最大63岁,平均32.8岁。本病好发于青壮年,以25～40岁发病率最高,约占本组病例的84％。男性19例,女性2例。 12例发生于膝关节,9例肘关节,均为     

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。     

滑膜骨软骨瘤病的X线诊断(附15例报告)

滑膜骨软骨瘤病是临床上少见的关节疾病，以形成关节内单发或多发的游离体为特征。X线检查对确定诊断和了解手术切除或复发情况均有较大的价值，现就我院1989年～2003年间诊治的15例报告如下。     

Synovial osteochondromatosis in a 9-year-old girl: clinical and histopathological appearance

This article reports the clinical and histopathological appearance of synovial osteochondromatosis in the right knee joint of a 9-year-old girl. Initial symptoms such as monoarticular joint swelling led to further diagnostic procedures with the aid of different imaging techniques including X-ray examination and MRI. The definitive diagnosis was based on histopathological findings after performing arthroscopy of the affected joint and the intraoperative appearance of the synovial lesions. Besides antiphlogistical drug-therapy, the treatment of choice is synovectomy.     

Computed tomography feature of synovial osteochondromatosis

Synovial osteochondromatosis in the knee joint is rarely a confusing diagnostic problem. Diagnosis depends on the clinical circumstances of the case and a radiologic interpretation which can exclude soft tissue tumors with calcifications and other malignant tumors characterized by the presence of multiple osteo-cartilaginous bodies. The relative value of computed tomography (CT) in the diagnosis of synovial osteochondromatosis is emphasized and the differential diagnosis discussed.     

膝关节腔内游离体病变的影像学诊断

目的：总结分析膝关节腔内游离体病变的影像学表现。方法：回顾性分析24例经病理证实的膝关节腔内游离体病变的影像学表现,观察病变的形态及结构特征。结果：滑膜骨软骨瘤病5例,滑膜软骨肉瘤1例,色素沉着绒毛结节性滑膜炎2例,神经营养性膝关节病1例,骨性关节病7例,剥脱性骨软骨炎4例,血肿钙化2例,关节囊滑液钙化2例。影像学主要表现为关节间隙及或关节囊内单发或多发游离体并相邻骨质的不同程度改变或无骨质改变,伴或不伴关节积液。结论：膝关节腔内含游离体的某些病变具有特征性影像征象,可明确诊断,影像征象不典型者需结合临床病史及多种影像表现综合分析。     

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.     

Calcified bodies in popliteal cysts: a characteristic radiographic appearance.

Calcified bodies in popliteal cysts have a characteristic radiographic appearance which can be confirmed by arthrography. Calcified bodies may arise in the true joint due to trauma, arthropathy resulting in joint destruction, or synovial osteochondromatosis. These calcified loose bodies may pass into a popliteal cyst through posterior joint-bursal communications or can arise in a popliteal cyst by chondrometaplasia. Correct radiographic interpretation will exclude soft tissue tumors and vascular lesions as differential considerations. Management of these patients will be determined by the clinical circumstances since neither popliteal cysts nor synovial osteochondromatosis are necessarily symptomatic.