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一种病因不寻常的膝关节僵硬。

A knee stiffness unusual etiology.

作者信息

Zitouna Khaled, Riahi Hend, Zheni Alya, Rekik Sonia, Arfa Wajdi, Barsaoui Maher

出版信息

Tunis Med. 2019 Nov;97(11):1307-1310.

Abstract

Progressive unilateral knee stiffness is an uncommon complaint in older adult. Tumor and specific infection should be considered in addition to osteoarthritis. We report a case of intracapsular and paraarticular chondroma in the infrapatellar Hoffa's fat pad that presented as a painless limited knee in 64-year old man. A physical examination revealed a firm, movable mass in the infrapatellar area. Radiographs and Magnetic resonance images showed an ovoid, well-defined, soft tissue mass with focal calcification in the infrapatellar fat pad. The mass was completely resected surgically through a medial parapatellar approach. The final pathology revealed an intracapsular and paraarticular chondroma. At follow-up, 3 years after the operation, patient was pain-free, with complete recovery of the range of motion of the knee and without any clinical or radiographic evidence of recurrence. Intracapsular and paraarticular chondroma is a rare benign lesion of the large joints (mostly the knee). The Pathogenesis of these tumours is controversial. The diagnosis is made with correlation of clinical, radiological and histological features. The treatment of choice is surgical excision.

摘要

进行性单侧膝关节僵硬在老年人中是一种不常见的症状。除骨关节炎外,还应考虑肿瘤和特定感染。我们报告一例64岁男性患者,髌下 Hoffa 脂肪垫内的关节内及关节旁软骨瘤,表现为无痛性膝关节活动受限。体格检查发现髌下区域有一个质地坚硬、可活动的肿块。X 线片和磁共振成像显示髌下脂肪垫有一个椭圆形、边界清晰、伴有局灶性钙化的软组织肿块。通过内侧髌旁入路对肿块进行了手术完整切除。最终病理显示为关节内及关节旁软骨瘤。术后3年随访时,患者无疼痛,膝关节活动范围完全恢复,无任何临床或影像学复发证据。关节内及关节旁软骨瘤是大关节(主要是膝关节)的一种罕见良性病变。这些肿瘤的发病机制存在争议。诊断需结合临床、放射学和组织学特征。治疗的首选方法是手术切除。

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