Groulier P, Franceschi J P, Curvale G, Dufour M, Roux H
Service de Chirurgie Orthopédique, Hôpital de la Conception, Marseille.
Rev Rhum Mal Osteoartic. 1991 Apr;58(4):259-67.
This study of 16 cases of pigmented villonodular synovitis of joints treated by the same surgical team involved 6 cases of the localized or nodular form and 10 cases of the diffuse form. The knee was the commonest joint involved (12 cases), with involvement of the hip (3 cases) and foot (1 case) being rarer. Bone invasion is usual when the joint is narrow (hip, foot) but is rarer in the knee where joint capacity is greater (5 cases out of 12). Clinical symptomatology is rarely typical. Hemarthrosis, the most suggestive sign, was found in only two cases out of twelve. While the final diagnosis must always be based upon histology, great help may be provided by modern techniques such as arthroscopy, computed tomography and above all MRI, the presence of hemosiderin being shown by a low signal in T1 which decreases even further in T2. Treatment is based upon surgical synovectomy, with advanced osteoarticular lesions requiring joint replacement.
本研究中，同一手术团队治疗了16例关节色素沉着绒毛结节性滑膜炎患者，其中局限性或结节性6例，弥漫性10例。膝关节是最常受累的关节（12例），髋关节受累（3例）和足部受累（1例）较少见。当关节狭窄时（髋关节、足部）骨侵犯常见，但在膝关节中较少见，因为膝关节的关节容量较大（12例中有5例）。临床症状很少具有典型性。最具提示性的体征——关节积血，在12例中仅2例出现。虽然最终诊断必须始终基于组织学，但现代技术如关节镜检查、计算机断层扫描尤其是磁共振成像（MRI）可提供很大帮助，含铁血黄素在T1加权像上表现为低信号，在T2加权像上信号进一步降低。治疗基于手术滑膜切除术，对于晚期骨关节病变需要进行关节置换。
