超声在坐骨结节滑膜囊肿诊断治疗中的价值

目的探讨坐骨结节滑膜囊肿的超声表现及诊断治疗价值.方法分析坐骨结节滑膜囊肿声像图特征性改变及手术病理结果对照;其中14例患者在超声引导下行囊肿穿刺治疗.结果 33例坐骨结节滑膜囊肿的声像图具有其特征性,大部分呈多房状囊肿,囊壁上见有绒毛状突起物及团状漂浮物,边界清晰;结果与手术及穿刺病理诊断完全相符合;超声引导囊肿穿刺治疗创伤小、准确性高.结论超声可作为坐骨结节滑膜囊肿诊断及穿刺治疗中的首选方法.     

髋关节囊肿1例报告

患者,女,35岁,2年前发现右腹股区包块,质韧、搏动性,大小约4cm×6cm,边界清晰,活动性略差,无压痛。后逐渐出现右腿肿胀,右腿内侧麻木感,无间歇性跛行、静息痛、下肢溃疡。于当地医院就诊,B超提示右腹股沟髂动脉下囊性肿物,双下肢深静脉流速低,未予治疗。患者自述2年来肿物增大不明显。此次为明确诊治就诊我院。查体:一般情况良好,双下肢     

髋关节滑膜囊肿致股静脉外压的临床分析

目的 探讨髋关节滑膜囊肿致股静脉外压,造成股静脉回流障碍的诊疗体会。方法 2008-01—2016-10间南乐县中兴医院及河南大学第一附属医院共诊治11例髋关节滑膜囊肿压迫股静脉患者,回顾性分析患者的临床资料。结果 11例患者均接受影像学检查,其中股静脉外压性改变的检出率为:彩色多普勒超声检查100%(11/11),腹股沟区CT检出率20%(1/5),磁共振成像(MRI)检出率100%(7/7),股静脉造影检出率100%(5/5),股静脉CTV检出率100%(2/2)。本组11例患者均接受髋关节滑膜囊肿切除术,术后临床症状及体征消失,复查彩超股静脉正常,未见囊肿复发。结论 彩超是一种经济有效诊断髋关节滑膜囊肿致股静脉外压并回流障碍的检查手段,操作简便无创,可有效降低误诊率。手术切除囊肿是治疗本病的有效方法。     

椎管内滑膜囊肿及腱鞘囊肿

滑膜囊肿和腱鞘囊肿为起自关节旁组织的囊肿,常见于腕、膝、踝、足等关节附近,起自脊椎关节突关节旁的滑膜囊肿和腱鞘囊肿较为少见[1-15]。虽然本病在国内外文献中的报道较少,但考虑到每位神经外科、骨科和放射科医生都可能会遇到,故我们对最近几年的医学文献进行了检索,对本病作一介绍。一、病理改变滑膜囊肿有蒂附着于关节囊内,囊内充满草黄色清亮的滑液,也可见含铁血黄素,有时还含有气体。囊壁由含有血管的多层绒毛结节状增生的结缔组织、疏松的粘液样结缔组织或胶原纤维以及弹力纤维构成。囊肿内壁被覆假复层柱状滑膜上皮细胞,…     

髋关节滑膜软骨瘤病的诊断与治疗

[目的]探讨髋关节滑膜软骨瘤病的早期诊断与手术疗效。[方法]5例髋关节原发性滑膜软骨瘤病患者,左侧3例,右侧2例。采用髋关节Smith-Petersen切口十字形切开关节囊进入关节腔切除增生肥厚滑膜、清除游离体。[结果]随访6～48个月,平均28个月,全部治愈。[结论]该病早期诊断困难,临床、放射学及病理检查相结合是确诊关键;采用髋关节前外侧入路显露术清除游离体、切除病变滑膜,疗效确切。     

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。     

髋关节原发性滑膜软骨瘤病的诊断与治疗

目的 探讨髋关节原发性滑膜软骨瘤病的早期诊断与手术疗效。方法 5例髋关节原发性滑膜软骨瘤病患者,左侧2例,右侧3例,采用髋关节后外侧入路加大转子截骨入路显露髋关节,其中4例行单纯游离体摘除术,1例行病变滑膜切切除加游离体摘除术。结果 随访时间6-36个月,平均18个月。治愈3例,好转1例,未愈1例。结论 该病早期诊断困难,临床、放射学及病理检查相结合是确诊关键;采用髋关节后外侧入路加大转子截骨显露术摘除游离体、切除病变滑膜,疗效确切。     

关节镜下小切口治疗髋关节滑膜软骨瘤病

2004年7月～2009年10月,我们采用关节镜结合小切口治疗3例髋关节滑膜软骨瘤病患者,取得较好效果,报道如下.     

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。     

髋关节滑膜软骨瘤病1例

患者,男,38岁。左髋关节隐痛伴活动受限渐加重8年。查体：左髋关节腹股沟处压痛阳性,髋关节处于半屈曲位、伸直、完全屈曲、内收、外旋受限CT检查示：左侧髋关节囊增厚,密度增高,关节腔内见散在的多发大小不等的桑椹状、     

左髋关节滑囊囊肿1例

患者,女,40岁,因“发现左腹股沟区包块半年,增大伴疼痛3个月”入院。查体：左侧腹股沟韧带中点偏内侧下方可扪及3．0cm×3．5cm×4．5cm大小包块,质韧,有压痛,移动度小,挤压后包块不消失,局部皮肤色泽正常。活动左髋关节包块不移位,过伸左髋关节左大腿前侧放射性痛。血象正常。B超示：左大腿根部一3．0cm×3．5cm×4．0cm大小液性暗区,     

Primary synovial chondromatosis of the hip joint (PrSC of the hip): A retrospective cohort analysis and review of the literature

IntroductionPrimary synovial osteochondromatosis (SOCM) or Synovial chondromatosis (SC) of the hip is a benign metaplastic condition of the synovium that is rare and may present with a spectrum of clinical features and radiological findings.Patients and methodsA retrospective search using the keyword ‘Synovial chondromatosis’ (SC) of the hip was performed at a tertiary care orthopaedic referral centre in the UK and a hospital in India. The radiology images were collected from our Picture Archiving and Communication System (PACS) and Radiology Information System (RIS), over 15 years. The patient's data was collated with Electronic Patient Records (EPR), RIS, and correlated with histo-pathology laboratory records where available. The demographic details of the patients, their clinical symptoms, imaging details, and management outcomes were collected.ResultsWe found 15 cases, with a mean age of 36.53 years (range: 14–50 years). There were 9 male and 6 female patients. The follow-up ranged from 1 year to 6 years. Predominantly unilateral presentation with insidious onset of symptoms was found. A spectrum of radiological Imaging was undertaken. Management strategies included supervised observation, arthroscopic or open synovectomy, and hip arthroplasty. No malignant transformation was found in the analysed cohort.ConclusionPrimary ‘Synovial chondromatosis’ of the hip had a male preponderance in our cohort, presenting with a range of clinical features. Radiologically, Magnetic Resonance Imaging (MRI) was the commonest modality of cross-sectional imaging utilised and crucial for the diagnosis, evaluating underlying articular involvement including guiding appropriate patient management presenting with Primary ‘Synovial chondromatosis’ of the hip.     

儿童髋关节滑膜嵌顿症的关节镜诊断与治疗

儿童髋关节滑膜嵌顿症是一种临床较常见的小儿骨科疾病，由滑膜皱襞嵌压在关节间隙而引起。有学者报道MRI和B型超声可以观察到嵌顿的滑膜。笔者尝试应用关节镜手术诊断和治疗这一疾病。     

髋关节滑膜软骨瘤病临床病例诊治分析

目的探讨髋关节滑膜软骨瘤病的临床、影像学表现、手术治疗方案的选择及其术后疗效。方法对本组2001年1月到2011年6月间收治的7例髋关节的滑膜软骨瘤病例因应病变程度差异分别采用关节镜或开放手术下关节滑膜切除,游离体清除以及人工髋关节置换等治疗手段,就术前临床表现、影像学资料进行回顾性总结,并对术后疗效进行追踪随访。结果 2例滑膜病变及游离体局限者采取关节镜下手术,2例关节内游离体分布及滑膜病变较为广泛行开放手术清理,Harris评分由术前平均49.3分(42～56分)改善为术后末次随访平均89.5分(86～92分),髋关节活动未再有弹响或交锁情况。上述4例,就骨关节炎进展作评估,采用Kellgren和Lawrence评级,术前1级者2例,末次随访评级均维持1级;术前2级者2例中1例末次随访升至3级。另3例合并严重骨性关节炎,行人工髋关节置换,术前Harris评分平均34.3分(32～36分),末次随访评分平均90.3分(88～92分)。结论认真地辨析病例特点,完善的术前影像学检查评估,因应实际选择不同术式,可获得良好治疗效果。     

Cystic lesion around the hip joint

This article presents a narrative review of cystic lesions around the hip and primarily consists of 5 sections: Radiological examination, prevalence, pathogenesis, symptoms, and treatment. Cystic lesions around the hip are usually asymptomatic but may be observed incidentally on imaging examinations, such as computed tomography and magnetic resonance imaging. Some cysts may enlarge because of various pathological factors, such as trauma, osteoarthritis, rheumatoid arthritis, or total hip arthroplasty (THA), and may become symptomatic because of compression of surrounding structures, including the femoral, obturator, or sciatic nerves, external iliac or common femoral artery, femoral or external iliac vein, sigmoid colon, cecum, small bowel, ureters, and bladder. Treatment for symptomatic cystic lesions around the hip joint includes rest, nonsteroidal anti-inflammatory drug administration, needle aspiration, and surgical excision. Furthermore, when these cysts are associated with osteoarthritis, rheumatoid arthritis, and THA, primary or revision THA surgery will be necessary concurrent with cyst excision. Knowledge of the characteristic clinical appearance of cystic masses around the hip will be useful for determining specific diagnoses and treatments.     

Arthroscopic surgery for synovial chondromatosis of the hip: a report of two cases

We have used arthroscopy in the treatment of synovial chondromatosis of the hip joint. Two patients complained of pain of the hip joint that was aggravated by weight bearing. On admission, range of motion of the affected hip joints was slightly restricted. At hip arthroscopy, osteochondral loose bodies were removed from the joint and partial synovectomy was performed. Histologic examination revealed synovial chondromatosis. Pain relief was obtained in both patients postoperatively.     

Spontaneous remission of a solitary intraspinal synovial cyst of the lumbar spine

We report on a 15-year-old boy in whom a spontaneous remission of a symptomatic synovial cyst, possibly emanating from the L4-5 facet joint, was noted. The medical history suggested that sport-related overactivity and/or minor trauma was the underlying cause. Conservative treatment for several months may be one treatment option if the cyst wall is not calcified and the symptoms and signs related to radiculopathy show a gradual decrease. Received: 26 February 1999/Revised: 2 September 1999/Accepted: 16 September 1999     

1328例汉族和维吾尔族新生儿髋关节超声测量研究

为探讨先天性髋脱位（ＣＤＨ）的有关因素,作者采用Ｅｎｇｅｓａｅｔｅｒ、Ｔｅｒｊｅｓｅｎ、Ｇｒａｆ、Ｍｏｒｉｎ－Ｈａｒ－ｃｋｅ四种超声方法对１３２８名汉维新生儿髋关节进行了检查。结果表明：汉维新生儿之间差异均无统计学意义;男女髋关节各值差异有显著性意义（Ｐ＜０．０００５）,ＣＤＨ发病率女孩明显高于男孩。作者认为：我国各地区、各民族之间ＣＤＨ发病率的差异,与新生儿髋臼深浅即头臼覆盖率无明显关系,可能是由于其它先天或后天因素所致;男女ＣＤＨ发病率不同,与新生儿期女性髋臼深度值即头臼覆盖率小于男性有关。     

正常人髋关节滑膜细胞有限细胞系的建立及其生物学特性的研究

目的 建立正常人髋关节滑膜细胞系,为进一步研究磨损颗粒在骨－假体界面的作用机制提供体外实验模型。方法 从正常人髋关节滑膜取材,纱巾组织块法原代培养, 1∶ 2传代培养,进行活细胞形态、组织学和电镜观察,测定细胞增殖及活性参数,鉴定细胞染色体,以鼠抗人 CD68单克隆抗体做免疫组化染色 (SABC),分析细胞类型。结果 原代培养 14 d滑膜细胞从组织块边缘逸出, 21 d密集生长开始传代。传代细胞 12 h内完全贴壁,分裂指数第 4 d最高,然后回落,细胞数量逐渐增加,第 7 d达高峰,倍增时间为 25.3 h。传至 21代,细胞生长及特性稳定,染色体正常。第 5代冻存细胞复苏良好。细胞系由形态、核型和超微结构不同的大、小两种细胞构成,其中小型细胞 CD 68阳性,占 23.17％± 5.60％ (x± s)。结论 体外培养可获得生物学特性稳定的正常人髋关节滑膜细胞系,并保留巨噬细胞样细胞 (MCs)和成纤维细胞样细胞 (FCs),其不同的形态特征为镜下区分提供了依据,是研究磨损颗粒作用机制较好的体外模型。