Kim Dong Hyun, Min Seunggi, Lee Hyun Joo, Kim Hee-June, Lee Hoseok, Yoon Jong Pil
Department of Orthopaedic Surgery, Kyungpook National University School of Medicine, Daegu, Korea.
Department of Radiology, Kyungpook National University School of Medicine, Daegu, Korea.
Clin Shoulder Elb. 2019 Mar 1;22(1):46-49. doi: 10.5397/cise.2019.22.1.46. eCollection 2019 Mar.
A 73-year-old woman presented with a recurrent cystic mass around her left olecranon. She had a history of 8 steroid injections due to elbow pain beginning 3 years ago and twice had undergone aspiration of olecranon bursitis that developed two months prior to presentation. She had been taking medications for hypertension and diabetes with no pertinent past history. On magnetic resonance imaging (MRI), there were multiple nodules in the olecranon bursa, which were isointense to muscle on T1-weighted images and hyperintense to muscle on T2-weighted images. Our initial diagnosis was synovial chondromatosis. On bursoscopy, masses of gray-white colored nodules were observed in the bursa. Finally, synovial chondromatosis and non-tuberculous mycobacterial infection were concurrently diagnosed. In conclusion, uncalcified synovial chondromatosis and rice bodies can have similar visual and MRI characteristics; therefore, we suggest that clinicians should be aware of the possibility of other infections in cases of this type.
一名73岁女性因左鹰嘴周围反复出现囊性肿块前来就诊。她有因肘部疼痛于3年前开始接受8次类固醇注射的病史,且在就诊前两个月曾两次对发生的鹰嘴滑囊炎进行穿刺抽吸。她一直在服用治疗高血压和糖尿病的药物,无相关既往病史。磁共振成像(MRI)显示,鹰嘴滑囊内有多个结节,在T1加权图像上与肌肉等信号,在T2加权图像上信号高于肌肉。我们最初的诊断是滑膜软骨瘤病。在滑囊镜检查中,发现滑囊内有灰白色结节团块。最终,同时诊断出滑膜软骨瘤病和非结核分枝杆菌感染。总之,未钙化的滑膜软骨瘤病和米粒体可具有相似的视觉和MRI特征;因此,我们建议临床医生在这类病例中应意识到存在其他感染的可能性。