四肢关节色素性绒毛结节性滑膜炎的骨侵袭性

目的：探讨色素性绒毛结节性滑膜炎对周围骨质侵袭的机理、临床诊断和外科治疗。方法：７例四肢骨关节内的色素性绒毛结节性滑膜炎经手术病理确诊。发生在膝关节３例、髋关节３例、踝关节１例。Ｘ线片见发生在膝关节为侵入性骨质破坏，发生在髋、踝关节多为关节面的腐蚀性破坏。结果：７例均行关节内病变的滑膜组织切除术，并对受累的骨质进行刮除。随访１月～１０年，无局部复发。结论：色素性绒毛结节性滑膜炎侵及骨质较少见，临床表现及Ｘ组片更无典型特征，术前确诊率不高。治疗以滑膜彻底切除为主，对与骨质粘连明显的病例，可行关节盛开有术或关节置换术。

Pigmented Villonodular Synovitis with Invasion of Bone

Objective: To investigate the etiologic pathogenesis,clinical features and the surgical treatment of the pigmented villonodular synovitis with invasion of bone.Methods:7 cases of the pigmented villonodular synovitis with invasion of bone were proved with plain X-ray film and postoperative pathology three cases were located in the knee joint,three in the hip joint and one in the ankle joint.X-ray film showed the invasive osteosclerosis.Results:All cases were treated with synovectomy.Followed up period extended from 1 month to 10 years,good function were seen in all cases and there was no recurrence.Conclusions:The pigmented willonodular synovitis with invasion of bone is rarely in clinical case,there are no typical features in X-ray film.Synovectomy is an effective treatment,the arthoplasty and total hip replacement were suited to the bone invasion seriously.