Radiologie ostéo-articulaire, Hôpital Lariboisière, 2 rue Ambroise Paré, 75475 Paris Cedex 10, France.
Skeletal Radiol. 2013 Sep;42(9):1323-7. doi: 10.1007/s00256-013-1625-4. Epub 2013 May 9.
Intratendinous ganglia are rare. We report the case of a sedentary woman with chronic mechanical anterolateral pain of the knee and an extensive ganglion of the patellar tendon as indicated on magnetic resonance (MR) and ultrasound (US) examinations. There was evidence of a high-riding patella, patellar malalignment and patellar tendon-lateral femoral condyle friction syndrome with significantly close contact between the patellar tendon and the lateral facet of the femoral trochlea. The ultrasound-guided aspiration of the ganglion enabled a localized injection of an anti-inflammatory drug (cortivazol) and the cytopathological examination of the fluid, which confirmed the diagnosis. Clinical improvement was maintained with knee rehabilitation and was satisfactory at follow-up after 1 year. To our knowledge, we report the first case of a ganglion of the patellar tendon subsequent to patellar tendon-lateral femoral condyle friction syndrome. We found that this case was illustrative of mucoid degeneration in connective tissue due to chronic repetitive microtraumas. Additionally, this case provided the opportunity to discuss the management of this condition in a sedentary individual with a high-riding patella and patellar malalignment.
滑囊是一种常见的发生于肌腱周围的结构,而滑囊内的腱鞘囊肿则较为少见。我们报告了 1 例久坐女性的病例,其慢性机械性膝关节前外侧疼痛,膝关节磁共振(MR)和超声(US)检查均提示髌腱广泛腱鞘囊肿。该患者存在高位髌骨、髌骨对线不良以及髌骨外侧髁与股骨滑车摩擦综合征,其髌腱与股骨滑车外侧关节面之间存在明显的紧密接触。超声引导下对滑囊进行抽吸,并向滑囊中注射抗炎药物(曲安奈德),同时对滑囊液进行细胞学检查,最终明确了诊断。在膝关节康复治疗后,患者的临床症状得到了持续改善,1 年后的随访结果令人满意。据我们所知,我们首次报告了髌骨外侧髁与股骨滑车摩擦综合征后继发髌腱腱鞘囊肿的病例。我们发现,本例是由于慢性、反复性微创伤导致的黏液样变性在结缔组织中的表现。此外,该病例还为我们提供了一个机会,讨论了对于久坐、高位髌骨和髌骨对线不良的个体,如何对这种情况进行治疗。