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术前诊断为青年男性腕关节关节内游离体的伴有砂粒体样钙化的腱鞘炎:病例报告

Tenosynovitis With Psammomatous Calcification Preoperatively Diagnosed as Intra-Articular Free Body of the Young Male Wrist: A Case Report.

作者信息

Nakai Ikuo, Imamura Tetsuo, Nishida Jun

机构信息

Department of Orthopaedic Surgery, Nishi Omiya Hospital, Saitama, Japan.

Department of Life Care, Teikyo Junior College, Tokyo, Japan.

出版信息

J Hand Surg Glob Online. 2023 Aug 29;5(6):845-848. doi: 10.1016/j.jhsg.2023.08.001. eCollection 2023 Nov.

Abstract

Tenosynovitis with psammomatous calcifications is a rare condition primarily affecting female patients in the distal extremities. This case report presents a unique instance of tenosynovitis with psammomatous calcification in a 31-year-old man presenting with wrist pain. Initial misdiagnosis and unsuccessful steroid injections prompted further investigation, leading to the discovery of an extra-articular calcified mass. Arthroscopic resection was attempted but found to be unnecessary because the lesion was located outside the joint. Histopathological examination confirmed the diagnosis of tenosynovitis with psammomatous calcification. After mass removal, the patient experienced relief from wrist pain and resumed work within a month. Subsequent follow-ups at 9 months showed no recurrence of pain, with full range of wrist motion and no grip power weakness. This case highlights the importance of differentiating tenosynovitis with psammomatous calcification from intra-articular lesions, particularly in atypical presentations, and demonstrates the effectiveness of surgical intervention in resolving symptoms.

摘要

伴有砂粒体样钙化的腱鞘炎是一种罕见疾病,主要影响远端肢体的女性患者。本病例报告呈现了一名31岁男性因腕部疼痛而患伴有砂粒体样钙化的腱鞘炎的独特病例。最初的误诊和类固醇注射治疗失败促使进一步检查,从而发现了一个关节外钙化肿块。尝试进行关节镜下切除,但发现由于病变位于关节外而无必要。组织病理学检查确诊为伴有砂粒体样钙化的腱鞘炎。肿块切除后,患者腕部疼痛缓解,并在一个月内恢复工作。随后9个月的随访显示无疼痛复发,腕关节活动范围正常且握力无减弱。本病例强调了在非典型表现中鉴别伴有砂粒体样钙化的腱鞘炎与关节内病变的重要性,并证明了手术干预在缓解症状方面的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5577/10721493/c6ad9a4f7713/gr1.jpg

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