Dhanda Sunita, Quek Swee Tian, Bathla Girish, Jagmohan Pooja
Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Wing, Singapore 119074.
Malays J Med Sci. 2014 Mar;21(2):4-19.
Definitive determination of the cause of articular swelling may be difficult based on just the clinical symptoms, physical examinations and laboratory tests. Joint disorders fall under the realms of rheumatology and general orthopaedics; however, patients with joint conditions manifesting primarily as intra-articular and peri-articular soft tissue swelling may at times be referred to an orthopaedic oncology department with suspicion of a tumour. In such a situation, an onco-radiologist needs to think beyond the usual neoplastic lesions and consider the diagnoses of various non-neoplastic arthritic conditions that may be clinically masquerading as masses. Differential diagnoses of articular lesions include infectious and non-infectious synovial proliferative processes, degenerative lesions, deposition diseases, vascular malformations, benign and malignant neoplasms and additional miscellaneous conditions. Many of these diseases have specific imaging findings. Knowledge of these radiological characteristics in an appropriate clinical context will allow for a more confident diagnosis.
仅根据临床症状、体格检查和实验室检查，可能难以明确关节肿胀的原因。关节疾病属于风湿病学和普通骨科学领域；然而，主要表现为关节内和关节周围软组织肿胀的关节疾病患者有时可能会因怀疑肿瘤而被转诊至骨肿瘤科室。在这种情况下，肿瘤放射科医生需要超越常见的肿瘤性病变，考虑各种可能在临床上伪装成肿块的非肿瘤性关节炎疾病的诊断。关节病变的鉴别诊断包括感染性和非感染性滑膜增生性病变、退行性病变、沉积性疾病、血管畸形、良性和恶性肿瘤以及其他杂项疾病。这些疾病中的许多都有特定的影像学表现。在适当的临床背景下了解这些放射学特征将有助于做出更可靠的诊断。
