Yoong-Leong Oh Jacob, Tan Ker-Kan, Wong Yue-Shuen
Department of Orthopaedic Surgery, Alexandra Hospital, Singapore.
Knee. 2008 Jan;15(1):58-60. doi: 10.1016/j.knee.2007.09.003. Epub 2007 Nov 28.
Osteochondroma is the most common bone tumour and is usually found around the knee. Typical presentations range form painless masses around the joint to mechanical irritation caused by direct pressure over surrounding muscles. Snapping of the knee caused by an osteochondroma however has not been described in literature.
An active 19-year-old gentleman presented with snapping of the left medial hamstring tendon for over 5 years, but with recent increase in frequencies of attack. The patient was initially diagnosed to have a sporting injury. Radiological investigation showed an opaque lesion on the medial border of the proximal tibia, which was suggestive of an osteophyte.
The lump was surgically excised and the patient made good recovery with resolution of symptoms. Histological results revealed the lesion to be that of an osteochondroma.
Although rare, osteochondroma should be considered as a differential when approaching a case of snapping knee pain.
骨软骨瘤是最常见的骨肿瘤，通常见于膝关节周围。典型表现从关节周围无痛性肿块到周围肌肉直接受压引起的机械性刺激不等。然而，文献中尚未描述由骨软骨瘤引起的膝关节弹响。
一名活跃的19岁男性，左腘绳肌腱内侧弹响超过5年，但近期发作频率增加。患者最初被诊断为运动损伤。影像学检查显示胫骨近端内侧缘有一不透光病变，提示为骨赘。
肿块经手术切除，患者恢复良好，症状消失。组织学结果显示病变为骨软骨瘤。
尽管罕见，但在处理膝关节弹响疼痛病例时，应将骨软骨瘤视为鉴别诊断之一。
