Drosos G I, Pozo J L
2nd Orthopaedic Department, Athens Naval Hospital, Deinocratous 70, 11521 Athens, Greece.
Knee. 2005 Aug;12(4):275-9. doi: 10.1016/j.knee.2004.09.004.
There are few reports in the English literature of extra-articular lesions simulating intra-articular pathology of the knee. Two cases of histologically confirmed haemangiomas related to the distal femur, presenting with knee pain suggestive of medial meniscal damage, are reported. A 27-year-old woman presented with persistent anteromedial right knee pain despite having undergone two arthroscopies for medial meniscal damage. An MRI showed a soft tissue mass on the medial side of the distal femoral metaphysis. The symptoms resolved only after open resection of the lesion. Histology showed a periosteal haemangioma. The second patient, a 24-year-old woman, complained of posteromedial left knee pain for 3 months. Although a medial meniscal tear was suspected, an MRI showed a soft tissue mass close to the bone of the distal femoral diaphysis. The symptoms resolved after open resection of the lesion. Histology showed a soft tissue haemangioma. Both patients were asymptomatic with normal MRI scans 6 to 12 months postoperatively. Although meniscal tears can present in young patients without a history of trauma, an MRI is extremely useful in diagnosing other lesions causing similar symptoms. Haemangiomas around the knee are rare, in particular periosteal haemangiomas of the distal femur as no report has been found in the English literature.
英文文献中关于模拟膝关节关节内病变的关节外病变的报道很少。本文报告了两例经组织学证实的与股骨远端相关的血管瘤病例,患者均表现出提示内侧半月板损伤的膝关节疼痛。一名27岁女性尽管因内侧半月板损伤接受了两次关节镜检查,但仍持续存在右膝前内侧疼痛。磁共振成像(MRI)显示股骨远端干骺端内侧有一软组织肿块。仅在病变开放切除后症状才得以缓解。组织学检查显示为骨膜血管瘤。第二名患者是一名24岁女性,主诉左膝后内侧疼痛3个月。尽管怀疑有内侧半月板撕裂,但MRI显示股骨远端骨干靠近骨骼处有一软组织肿块。病变开放切除后症状缓解。组织学检查显示为软组织血管瘤。两名患者术后6至12个月均无症状,MRI扫描结果正常。尽管半月板撕裂可出现在无创伤史的年轻患者中,但MRI对于诊断引起类似症状的其他病变极为有用。膝关节周围的血管瘤很少见,尤其是股骨远端的骨膜血管瘤,因为在英文文献中未发现相关报道。