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表现为色素沉着绒毛结节性滑膜炎的膝关节结核

Knee Tuberculosis Presenting As Pigmented villonodular Synovitis.

作者信息

Ambulgekar Rajesh K, Jadhav Akshay

机构信息

Department of Orthopaedics, Dr. Shankarrao Chavan Government Medical College, Nanded, Maharashtra, India.

出版信息

J Orthop Case Rep. 2022 Oct;12(10):97-100. doi: 10.13107/jocr.2022.v12.i10.3384.

Abstract

INTRODUCTION

Extra pulmonary Tuberculosis (TB) May mimic other diseases in clinical presentation which might be difficult to differentiate and diagnose. Pigmented villonodular synovitis (PVNS) may closely resemble tuberculosis of the knee joint. In younger patients, without any other co-morbid conditions TB of knee joint and PVNS in the knee might present with involvement of the isolated joint, with swelling which is painful for long duration with restriction in the range of motion. Treatment of both the conditions differs vastly and delay in the treatment can result in permanent disfiguration of the joint.

CASE REPORT

A male 35 years old having a right knee painful swelling since last 6 months. The thorough physical examination, radiographs, and MRI suggest PVNS but an altogether different diagnosis is made after confirmatory investigations, i.e. Histopathological examination.

CONCLUSION

Clinical and radiological presentation of TB and PVNS can mimic each other . Therefore TB should be suspected specially in the like India (endemic). For confirmation of diagnosis hisptopathological and mycobacterial results are important.

摘要

引言

肺外结核病在临床表现上可能与其他疾病相似,难以鉴别和诊断。色素沉着绒毛结节性滑膜炎(PVNS)可能与膝关节结核极为相似。在年轻患者中,没有任何其他合并症时,膝关节结核和膝关节PVNS可能仅表现为单个关节受累,伴有肿胀、长期疼痛以及活动范围受限。这两种疾病的治疗方法差异很大,治疗延迟可能导致关节永久性畸形。

病例报告

一名35岁男性,右膝关节疼痛肿胀已持续6个月。全面的体格检查、X线片和磁共振成像(MRI)提示为PVNS,但在进行确诊检查,即组织病理学检查后,得出了完全不同的诊断结果。

结论

结核病和PVNS的临床及影像学表现可能相互类似。因此,在像印度这样的结核病流行地区,尤其应怀疑结核病。为确诊,组织病理学和分枝杆菌检测结果很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12d7/9983377/8c2d7192ea5a/JOCR-12-97-g001.jpg

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