Söylemez Mehmet Salih, Shattat Khaled M I, Çelik Aykut, Söylemez U Percem Orhan, Tosun Ilkay, Yıldırım Ayşenur Toksöz
Department of Orthopaedics and Traumatology, Umraniye Training and Research Hospital, Istanbul, Turkey.
Department of Orthopaedics and Traumatology, Faculty of Medicine, Istanbul Medeniyet University, Göztepe City Hospital, Istanbul, Turkey.
J Orthop Case Rep. 2022;12(5):1-5. doi: 10.13107/jocr.2022.v12.i05.2790.
Intra-articular tenosynovial giant cell tumor (IATGCT) is a type of tenosynovial giant cell tumor that typically occurs in the synovial tissues of large joints. It is also known as pigmented villonodular synovitis. Acute onset of the pain with irritable hip symptoms is very rare. In this paper, we presented two adolescents with acute onset of hip pain mimicking septic arthritis diagnosed with intra-articular tenosynovial giant cell tumor.
Healthy two adolescents, one male (14-year-old) and the other girl (15-year-old) with no history of the previous trauma or significant comorbidities were presented complaining of acute onset of hip pain to our emergency room. Although initial possible diagnosis was septic arthritis for both cases, laboratory findings were unequivocal for septic arthritis and magnetic resonance imaging (MRI) showed an intra-articular nodular mass. An open resection was performed and pathological evaluation revealed the masses to be intra-articular tenosynovial giant cell tumor. After 26 and 17 months follow-up there was no pain neither with activity nor in rest, hip range of motion was within normal ranges. There was no recurrence, avascular necrosis or destruction detected on control MRI for both patients.
IATGCT is a rare disease of the pediatric population involving the hip. Inflammation or infarction of the lesion can trigger irritable hip findings in children. This diagnosis should be kept in mind mainly in cases with serohemorrhagic aspirate and unequivocal laboratory findings.
关节内腱鞘巨细胞瘤（IATGCT）是腱鞘巨细胞瘤的一种类型，通常发生于大关节的滑膜组织。它也被称为色素沉着绒毛结节性滑膜炎。伴有髋关节激惹症状的疼痛急性发作非常罕见。在本文中，我们报告了两名青少年，他们以髋关节疼痛急性发作为表现，最初被误诊为化脓性关节炎，最终被诊断为关节内腱鞘巨细胞瘤。
两名健康青少年，一名男性（14岁），另一名女孩（15岁），既往无创伤史或重大合并症，因髋关节疼痛急性发作前来我院急诊室就诊。尽管最初两例患者都可能被诊断为化脓性关节炎，但实验室检查结果明确排除了化脓性关节炎，磁共振成像（MRI）显示关节内有一个结节状肿块。进行了开放性切除，病理评估显示肿块为关节内腱鞘巨细胞瘤。经过26个月和17个月的随访，患者活动及休息时均无疼痛，髋关节活动范围在正常范围内。两名患者的对照MRI检查均未发现复发、缺血性坏死或破坏。
IATGCT是一种累及髋关节的儿科罕见疾病。病变的炎症或梗死可引发儿童髋关节激惹表现。主要在抽出液为血清血性且实验室检查结果明确的病例中应考虑这一诊断。
