Chen Jun, Zhang Wen-Bing, He Jin-Zhou, Zhang Run, Cao Yin-Qiang, Liu Xing
Department of Orthopedic, Chongqing Children's Hospital, Chongqing Medical University, Chongqing, 400014, China.
Department of Orthopedic, Chongqing Children's Hospital, Chongqing Medical University, Chongqing, 400014, China.
Chin J Traumatol. 2018 Aug;21(4):238-242. doi: 10.1016/j.cjtee.2018.02.001. Epub 2018 Mar 26.
Developmental dysplasia of the hip (DDH) is one of the most common congenital disorders in childhood. Its diverse pathological changes require different treatments and result in different outcomes. Although many studies have been conducted on DDH, some special pathology is still unrecognized. We here presented a rare case of a one-year and eleven-month old girl with DDH; a half-free intra-articular osteocartilaginous tissue was found in her right hip joint. X-ray, computer assisted tomography (CT) and magnetic resonance imaging (MRI) were performed to evaluate the pathological changes. MRI revealed some positive findings. The patient experienced open reduction and histopathological examination of the small tissue. Through gross anatomy it is a half-free intra-articular osteocartilaginous tissue, which can fully match a fossa observed at the femoral head. Histopathological examination found that the tissue was composed of collagenous fiber and cartilage-like tissue. Interestingly, we found the expression of type I collagen according to immunohistochemical analysis, which indicated that the cartilage-like tissue was formed due to laceration of the articular cartilage. This kind of disorder should be included as one of the pathologies of DDH. The most possible origin of this tissue is the femoral head which we speculate may have been fractured before.
发育性髋关节发育不良(DDH)是儿童期最常见的先天性疾病之一。其多样的病理变化需要不同的治疗方法,并导致不同的结果。尽管已经对DDH进行了许多研究,但一些特殊病理仍未被认识到。我们在此报告了一例罕见的1岁11个月大患有DDH的女孩病例;在她的右髋关节中发现了一块半游离的关节内骨软骨组织。进行了X线、计算机断层扫描(CT)和磁共振成像(MRI)以评估病理变化。MRI显示了一些阳性结果。对该患者进行了切开复位并对小块组织进行了组织病理学检查。通过大体解剖发现它是一块半游离的关节内骨软骨组织,与在股骨头处观察到的一个窝完全匹配。组织病理学检查发现该组织由胶原纤维和软骨样组织组成。有趣的是,根据免疫组织化学分析我们发现了I型胶原的表达,这表明软骨样组织是由于关节软骨撕裂形成的。这种病症应被纳入DDH的病理类型之一。这种组织最可能的起源是股骨头,我们推测之前可能发生过骨折。