Yao M-S, Chang C-M, Chen C-L, Chan W P
Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
JBR-BTR. 2012 Nov-Dec;95(6):360-2. doi: 10.5334/jbr-btr.723.
We report the case of a 51-year-old woman who had suffered from right knee pain and stiffness for 40 years. Her symptoms had gradually worsened over the past 5 years. One year previously, when she first visited our clinic, plain radiographs and CT scan images had revealed synovial chondromatosis over the right knee. At the current admission, follow-up MRI showed synovial masses around the knee and worsening of endosteal cortical scalloping in the patella, femoral condyle, and tibial plateau. After diagnosis on the basis of frozen sections, the patient had total excision of the lesions and total knee athroplasty. Histological examination revealed synovial chondromatosis in the joint cavity and grade 1 chondrosarcoma invasion into the adjacent bone. In long-standing synovial chondromatosis, presentation with aggravated symptoms and deterioration on imaging findings should alert clinicians to the potential for malignant change.
我们报告了一例51岁女性病例,该患者右膝疼痛和僵硬已持续40年。在过去5年中,她的症状逐渐加重。一年前,当她首次就诊于我们诊所时,X线平片和CT扫描图像显示右膝患有滑膜软骨瘤病。本次入院时,随访的MRI显示膝关节周围有滑膜肿块,髌骨、股骨髁和胫骨平台的骨内膜皮质扇贝样变加重。在根据冰冻切片诊断后,患者接受了病变的完全切除和全膝关节置换术。组织学检查显示关节腔内有滑膜软骨瘤病,并有1级软骨肉瘤侵犯相邻骨骼。在长期的滑膜软骨瘤病中,症状加重和影像学表现恶化应提醒临床医生注意恶性变的可能性。