Mells Anthony J, Gosey G Max, Muldoon Michael P
Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
Department of Orthopedic Surgery, University of Arizona Arizona Health Sciences Center, Tucson, AZ, USA.
BMJ Case Rep. 2017 Jun 23;2017:bcr-2017-220349. doi: 10.1136/bcr-2017-220349.
Intra-articular lipoma of the hip is a rare entity, with only two reports published in the English-language literature. We present a case of successful arthroscopic resection of an intra-articular peripheral compartment lipoma in a 69-year-old woman with a coincident labral tear. This woman presented with left hip pain that developed gradually over 2 years and increased over 2 months. MRI showed a fat-intense mass in the anterior aspect of the hip joint, convincing for intra-articular lipoma. Physical examination in the operating room reproduced decreased range of motion and evidence of impingement but with a soft endpoint. Arthroscopy revealed an anterior intrasubstance labral tear, which was debrided. The mass was excised and confirmed as true lipoma on histology. The soft endpoint on examination illustrates that a large lipoma of the hip joint can cause clinical symptoms of impingement in the absence of bony abnormality or trauma.
髋关节内脂肪瘤是一种罕见的病症，英文文献中仅有两篇相关报道。我们报告一例成功通过关节镜切除一名69岁女性髋关节内周围间隙脂肪瘤的病例，该患者同时伴有髋臼唇撕裂。该女性因左髋部疼痛就诊，疼痛在2年中逐渐加重，并在2个月内进一步加剧。磁共振成像（MRI）显示髋关节前部有一高信号脂肪团块，确诊为关节内脂肪瘤。术中体格检查再现了活动范围减小和撞击征表现，但终点为软性。关节镜检查发现髋臼唇前部实质内撕裂，遂进行清理。切除肿物，组织学检查证实为真性脂肪瘤。检查中的软性终点表明，髋关节的大脂肪瘤在无骨质异常或创伤的情况下可引起撞击的临床症状。
