Sit Michelle, Higgs Jay B
San Antonio Uniformed Services Health Education Consortium, Rheumatology Service, Brooke Army Medical Center, Fort Sam Houston, San Antonio, TX, USA.
J Clin Rheumatol. 2009 Jun;15(4):185-9. doi: 10.1097/RHU.0b013e3181a628ab.
The ruptured popliteal synovial cyst is a common complication of chronic knee arthritis. In contrast, non-popliteal synovial rupture is less well recognized and may present a diagnostic dilemma. We report an 81-year-old woman who presented with chest wall pain and ecchymosis. Ultrasonography of the shoulder region readily diagnosed a dissecting parasynovial cyst. She developed the unusual complication of contralateral recurrence. Literature review revealed a small but important set of non-popliteal synovial ruptures in the regions of the shoulder, elbow, wrist, spine, hip, knee, and ankle. Local swelling, inflammation, ecchymosis, and nerve impingement may mimic other conditions. Awareness of the clinical presentations and a high index of suspicion are required to avoid diagnostic confusion. Management data are limited to case reports of arthrocentesis, injection, and very rarely, surgery.
腘窝滑膜囊肿破裂是慢性膝关节炎的常见并发症。相比之下，非腘窝滑膜破裂较少被认识，可能会带来诊断难题。我们报告一名81岁女性，她因胸壁疼痛和瘀斑就诊。肩部超声检查很容易诊断出一个滑膜旁夹层囊肿。她出现了对侧复发的不寻常并发症。文献回顾显示，在肩部、肘部、腕部、脊柱、髋部、膝部和踝部区域存在一小部分但重要的非腘窝滑膜破裂病例。局部肿胀、炎症、瘀斑和神经受压可能会与其他疾病相混淆。需要了解临床表现并保持高度怀疑，以避免诊断混乱。治疗数据仅限于关节穿刺、注射的病例报告，手术治疗则极为罕见。
