Chiffolot X, Ehlinger M, Bonnomet F, Kempf J F
Département d'Orthopédie, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, avenue Molière, 67098 Strasbourg Cedex.
Rev Chir Orthop Reparatrice Appar Mot. 2005 Sep;91(5):470-5. doi: 10.1016/s0035-1040(05)84365-x.
Pigmented villonodular synovitis can be localized or diffuse. Lesions predominate in the knee but all of the joints can be involved. Thirty cases in the glenohumeral joint have been reported in the literature. The different reports to date have not identified any specific clinical signs. Our female patient presented non-specific shoulder pain which persisted for three years. The plain x-rays were normal. MRI and arthroscan revealed an intra-articular pseudotumor. Arthroscopy was performed for tumor biopsy which was followed by total resection. The diagnosis of villonodular synovitis pseudotumor suspected at arthroscopy was confirmed at the pathology examination. The functional outcome was excellent and no recurrence has been observed at three years follow-up. Arthroscopy is less aggressive than open surgery for arthrotomy. Arthroscopy must be performed for diagnostic purposes since imaging findings are not specific. Arthroscopic synovectomy is the treatment of choice for pigmented villonodular synovitis in both the diffuse and pseudotumor forms.
色素沉着绒毛结节性滑膜炎可局限或弥漫性。病变以膝关节为主,但所有关节均可受累。文献报道了30例发生于盂肱关节的病例。迄今为止,不同的报告尚未发现任何特定的临床体征。我们的女性患者出现非特异性肩部疼痛,持续了三年。X线平片正常。MRI和关节造影显示关节内假肿瘤。进行关节镜检查以获取肿瘤活检,随后进行全切除。关节镜检查时怀疑的绒毛结节性滑膜炎假肿瘤诊断在病理检查中得到证实。功能结果极佳,在三年随访中未观察到复发。关节镜检查比切开手术的侵袭性小。由于影像学表现不具特异性,必须进行关节镜检查以明确诊断。关节镜下滑膜切除术是弥漫性和假肿瘤型色素沉着绒毛结节性滑膜炎的首选治疗方法。