Yu M X, He Z G, Zhang N Z
Peking Union Medical College Hospital.
Zhonghua Nei Ke Za Zhi. 1990 Dec;29(12):713-6, 764.
46 patients with knee joint arthritis were subjected to arthroscopic examination. The results were analyzed and its clinical significance was discussed. The postoperative diagnoses were rheumatoid arthritis in 19 cases, Sjögren syndrome in one, seronegative spondyloarthropathy in 4, gouty arthritis in one, tuberculous arthritis in one, pigmented villous nodular synovitis in two, undefined synovitis in 5, osteoarthritis in 8 and nonsynovitis conditions in 5. The most important indication of arthroscopic examination is for differential diagnosis of arthritis of unknown cause, such as rheumatoid arthritis with single knee joint involvement, osteoarthritis with symmetric large and small joints involvement as well as crystal induced arthritis. These conditions showed under arthroscope their special features in synovium both grossly, microscopically and immuno-pathologically. The synovial damage as observed through arthroscopic examination correlated to certain extent with the X-ray film changes of the knee joint, but direct visualization with the former is better than indirect imaging with the latter.
46例膝关节关节炎患者接受了关节镜检查。对结果进行了分析并讨论了其临床意义。术后诊断为类风湿关节炎19例、干燥综合征1例、血清阴性脊柱关节病4例、痛风性关节炎1例、结核性关节炎1例、色素沉着绒毛结节性滑膜炎2例、未明确的滑膜炎5例、骨关节炎8例、非滑膜炎情况5例。关节镜检查最重要的指征是用于不明原因关节炎的鉴别诊断,如单膝关节受累的类风湿关节炎、大小关节对称受累的骨关节炎以及晶体诱导的关节炎。这些情况在关节镜下在滑膜的大体、显微镜及免疫病理方面均显示出其特殊特征。通过关节镜检查观察到的滑膜损伤与膝关节X线片改变在一定程度上相关,但前者的直接可视化优于后者的间接成像。