Wittkop B, Davies A M, Mangham D C
MRI Centre, Royal Orthopaedic Hospital, Birmingham B31 2AP, UK.
Eur Radiol. 2002 Aug;12(8):2112-9. doi: 10.1007/s00330-002-1318-1. Epub 2002 Mar 19.
This article illustrates the imaging characteristics of primary synovial chondromatosis (PSC) using 20 cases referred to a tertiary orthopaedic oncology centre. Three quarters of patients presented with a large intra-articular soft tissue mass and a suspected clinical and radiological diagnosis of malignancy made in the referring centres. Radiographs demonstrated fine cartilaginous mineralisation in the soft tissue masses in 85% cases and bone erosions were shown on MR imaging in 80%. Malignant transformation to chondrosarcoma was proven in 2 cases with longstanding disease. There were no specific MR features to distinguish these cases with malignant change from PSC alone. Primary synovial chondromatosis should be considered in the diagnosis of the monarticular presentation of an intra-articular soft tissue mass, particularly in the presence of superficial bone erosions and signal voids due to the mineralisation.
本文介绍了在一家三级骨科肿瘤中心就诊的20例原发性滑膜软骨瘤病(PSC)的影像学特征。四分之三的患者表现为大的关节内软组织肿块,转诊中心做出了疑似恶性的临床和放射学诊断。X线片显示85%的病例软组织肿块中有细微的软骨矿化,80%的病例在磁共振成像(MR)上显示有骨质侵蚀。2例病程较长的病例证实发生了向软骨肉瘤的恶性转化。没有特定的MR特征来将这些发生恶性变化的病例与单纯的PSC区分开来。在诊断关节内软组织肿块的单关节表现时,应考虑原发性滑膜软骨瘤病,特别是在存在浅表骨质侵蚀和由于矿化导致的信号缺失的情况下。