病毒感染与小儿短暂性滑膜炎关系的研究

探讨小儿短暂性滑膜炎与病毒感染 ,特别是柯萨奇B组病毒 (CVB)感染的关系。方法 :采用酶联免疫吸附试验 (ELISA)对 16 2例小儿髋关节短暂性滑膜炎患儿静脉血和其中的 2 1例关节腔液进行病毒IgM抗体检测 ,柯萨奇病毒B组 (CVB)阳性者进行血清学分型及病毒分离。结果 :在 16 2例静脉血样本中病毒IgM阳性 6 2例 ,占总检数的 38.2 7% ,CVB -IgM2 6例占 16 .0 5 % ,AdV -IgM 19例占 11.73% ,CMV -IgM 10例占 6 .17% ,RSV -IgM 4例占 2 .4 7% ;在关节腔液中检出 9例CVB阳性 ,血清学分型 8例为CVB3,1例为CVB4 ,并分离出 1例CVB3。结论 :CVB和腺病毒 (AdV)是小儿髋关节短暂性滑膜炎感染的主要病毒 ,而且以CVB3为主。     

局限性结节性滑膜炎1例

患者,女,20岁,因右膝痛伴外侧肿物6年余,加重1个月入院。6年前,患者始觉右膝疼痛,时痛时止,曾在本地市人民医院检查诊为“生长痛”,未予处理。2个月后发现右膝外侧有一肿物约0.5cm×1cm×0.8cm,时有时无,疼痛无规律性,与天气变化无关,口服止痛药物效不显。1个月前,疼痛突然加重     

颞颌关节继发性滑膜炎的临床诊断

颞颌关节滑膜炎分为原发性和继发性两种，颞颌关节紊乱综合症的滑膜炎为继发性滑膜炎。本文通过对１０６例颞颌关节紊乱综合症患者的临床检查、关节许氏位以及关节上腔造影的Ｘ线检查，同时对４２例进行了关节内窥镜检查，在此基础上探讨了继发性滑膜炎的临床诊断标准．作者认为急性滑膜炎主要是以关节疼痛和滑膜血管的改变为主，慢性滑膜炎的临床症状与滑膜组织改变以及关节骨组织的改变均有关系。     

川崎病患儿髋关节滑膜病变的超声诊断及其临床意义

目的 :观察川崎病患儿髋关节滑膜病变的声像图表现及其发病特点。方法 :测量86例川崎病患儿髋关节滑膜囊的宽度 ,按照不同发病年龄和不同的病程时期分组 ,分别计算各组的阳性率 ,进行组间对照。结果 :86例患儿 ,动态观察总次数142例次。其中双侧阳性68例次 ;单侧阳性22例次 ;总阳性率63.4% ;双侧阴性52例次。发病年龄>12月的患儿髋滑膜炎 (SH)阳性率(69.2% )明显高于发病年龄≤12月的阳性率 (31.4% ) ;病程≥6月的患儿SH阳性率 (64.4% )明显高于发病年龄<6月的阳性率(51.55 % ) ,组间差异均有显著性。结论 :SH以双侧发病多见 ,并随年龄增长有增多的趋势。     

Neurogenic inflammation in osteoarthritis of the knee

Abstract

The synovium in a knee joint has an extensive neural network in the somatic and autonomic nervous systems. In medial compartmental osteoarthritis of the knee, neuropeptides were most abundant, with an especially large number of substance P and calcitonin gene-related peptide-immunoreactive free nerve endings. Some of the substance P-positive nerve endings were surrounded by monocytes. Substance P and calcitonin gene-related peptide were found more frequently in the medial than in the lateral or suprapatellar areas. Substance P-positive free nerve endings showed more dendritic morphologic features in the medial region than those in the lateral and suprapatellar regions, and small nerves were accompanied by newly developed vessels in synovial villi. In the medial region, the synovitis was more remarkable than in the lateral region. Patients suffering from medial compartmental osteoarthritis of the knee complain of pain on the anteromedial portion of the knee joint when walking or standing. Therefore, these findings suggest that free nerve endings containing substance P may be implicated in the development and persistence of inflammatory synovitis and the pain pathway in osteoarthritis of the knee.     

Application of Rhenium-186 Radiosynovectomy in Elbow Diffuse Pigmented Villonodular Synovitis. - A Case Report with Multiple Joint Involvement

After surgical therapy of diffuse pigmented villonodular synovitis (DPVNS), recurrence is seen in almost half of the patients. The effectiveness of radiosynovectomy (RSV) in preventing recurrence and complaints of DPVNS is well known. Elbow involvement in DPVNS is a very rare condition; therefore, RSV in elbow hasn’t been experienced widely. The aim of this case report is to show the effectiveness of RSV with rhenium-186 (Re-186) sulfide colloid. We applied Re-186 sulfide colloid to the elbow joint of DPVNS patients six weeks after arthroscopic synovectomy. As a result, the patient did not have any complaints, and our findings are compatible with residue or recurrence on magnetic resonance imaging (MRI) in sixth and twentieth month controls after administration. We concluded that Re-186 is an effective adjuvant therapy for the prevention of recurrence and complaints.     

Treatment of skin necrosis after radiation synovectomy with yttrium-90: a case report

Chronic synovitis, unresponsive to systemic medical therapy including agents, anti-inflammatory drugs and remission-inducing agents, and intra-articular administration of corticosteroids can be treated with surgical, chemical and radiation synovectomy. We reported a case of a 23 years old male. Skin radiation necrosis (4 x 5 cm) developed after an injection of Yttrium-90 (Y-90). Full-thickness skin graft had been applied but we were not able to succeed. Skin radiation necrosis was treated with Limberg's flap. As a result we recommend flap surgery instead of skin graft in skin radiation necrosis.     

膝关节色素沉着绒毛结节性滑膜炎MRI表现

目的探讨膝关节色素沉着绒毛结节性滑膜炎的MRI表现,提高对该疾病的认识。方法对我院经手术病理证实的27例膝关节PVNS的MRI表现进行回顾性分析。结果 27例PVNS中,弥漫型者22例,局限型者5例。所有弥漫型PVNS患者均表现为滑膜呈绒毛状或结节状增厚,T1WI呈低信号,T2WI及PDW呈不均匀稍高信号,增强扫描滑膜明显强化。膝关节周围脂肪垫区、髌上囊及腘窝可见大小不等软组织结节影。增厚滑膜及结节内见条片状或点状异常信号影,T1WI呈低信号,T2WI呈低信号,无明显强化。9例伴有关节软骨及软骨下骨破坏。前后交叉韧带受累1例。所有患者见不同程度关节积液。局限型者表现为关节腔内单发的软组织肿块,伴关节积液。结论膝关节PVNS具有较特征的MRI表现,MRI是诊断PVNS的首选方法。