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儿童色素沉着绒毛结节性滑膜炎:文献综述及病例报告

Pigmented villonodular synovitis in pediatric population: review of literature and a case report.

作者信息

Karami Mohsen, Soleimani Mehryar, Shiari Reza

机构信息

Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Shariati Ave., Tehran, 15514-15468, Iran.

出版信息

Pediatr Rheumatol Online J. 2018 Jan 17;16(1):6. doi: 10.1186/s12969-018-0222-4.

Abstract

BACKGROUND

Pigmented villonodular synovitis (PVNS) is a rare proliferative process in children that mostly affects the knee joint.

CASE PRESENTATION

The study follows the case of a 3-year-old boy presenting recurrent patellar dislocation and PVNS. Due to symptoms such as chronic arthritis, he had been taking prednisolone and methotrexate for 6 months before receiving a definitive diagnosis. After a period of showing no improvements from his treatment, he was referred to our center and was diagnosed with local PVNS using magnetic resonance imaging (MRI). The patient was treated for his patellar dislocation by way of open synovectomy, lateral retinacular release, and a proximal realignment procedure, with no recurrence after a 24-month follow-up.

CONCLUSION

PVNS may appear with symptoms resembling juvenile idiopathic arthritis, thus the disease should be considered in differential diagnosis of any inflammatory arthritis in children. PVNS may also cause mechanical symptoms such as patellar dislocation. In addition to synovectomy, a realignment procedure can be a useful method of treatment.

摘要

背景

色素沉着绒毛结节性滑膜炎(PVNS)是一种在儿童中罕见的增殖性病变,主要累及膝关节。

病例报告

本研究追踪了一名3岁男孩,其患有复发性髌骨脱位和PVNS。由于存在慢性关节炎等症状,在获得明确诊断前,他已服用泼尼松龙和甲氨蝶呤6个月。在经过一段时间治疗后未见改善,他被转诊至我们中心,并通过磁共振成像(MRI)被诊断为局限性PVNS。该患者通过开放性滑膜切除术、外侧支持带松解术和近端重新排列手术治疗髌骨脱位,经过24个月的随访未复发。

结论

PVNS可能表现出类似于幼年特发性关节炎的症状,因此在儿童任何炎性关节炎的鉴别诊断中都应考虑该疾病。PVNS也可能引起如髌骨脱位等机械性症状。除滑膜切除外,重新排列手术可能是一种有效的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76ac/5772710/d75f47519fcd/12969_2018_222_Fig1_HTML.jpg

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