膝关节色素沉着绒毛结节性滑膜炎

目的：探讨膝关节色素沉着绒毛结节性滑膜史（PVN）的临床特征、病理学改变和综合治疗的疗效．方法：对12例PVNS患者的诊断和治疗进行回顾性分析，对其临床体征、影像学及病理学检查特征、临床综合治疗等进行评价。结果：PVNS以膝关节肿病伴有咖啡色关节积液、MRI检查（T1和T2加权像）滑膜的低密度信号、滑膜内含有铁锈样色素斑等改变为临床特征。经膝关节镜探查并清除病变的滑膜，术后辅以^60Co放疗，PVNS患者100％（12例）膝关节肿胀、积疲消失．83％（10例）膝关节疼痛消失，100％（12例）屈膝活动恢复正常。结论：应用膝关节镜探查和病理学检查是诊断PVNS的关键；膝关节镜下清除病变的滑膜组织以厦术后^60Co放疗．可以有效地治疗弥漫性绒毛型和绒毛结节型PVNS。

Pigmented villonodular synovitis of the knee

Objective: To evaluate the clinical features,pathological changes,and combined therapy of pigmented villonodular synovitis(PVNS) of the knee.Methods: Retrospective analysis was performed in 12 PVNS patients,and the clinical signs,radiological and pathological changes,and combined therapy were evaluated.Results: The clinical features of PVNS included articular engorgement and pain associated with hydrarthrosis,decreased signal intensity on both T1-and T2-weighted MRI,and rust-like staining in synovium.After the combination therapy with removing abnormal synovium under arthroscope and radiotherapy with 60Co gamma-rays,the signs of articular engorgement and pain and hydrarthrosis disappeared in 10 of 12 PVNS patients,and articular movement restored to normal in all patients.Conclusion: It is important to establish the diagnosis of PVNS with arthroscopy and pathological examination.Diffuse villonodular PVNS could be effectively treated with arthroscopy and radiotherapy with 60Co gamma-rays.