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关节镜下胫骨近端后髁骨样骨瘤的治疗:病例报告及文献复习。

Arthroscopic treatment of osteoid osteoma in the posterior proximal tibia: A case report and literature review.

机构信息

Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan Province, China.

Fujian Medical University, Fuzhou, Fujian Province, China.

出版信息

Medicine (Baltimore). 2024 Feb 2;103(5):e37076. doi: 10.1097/MD.0000000000037076.

Abstract

BACKGROUND

Osteoid osteoma (OO) is a benign lesion characterized by an increased fibrous component in the bone marrow, presence of bone-like structures within the medullary cavity, and a surrounding sclerotic bone rim. Reports on OO located in the posterior proximal tibia are rare.

CASE SUMMARY

Herein, we report the case of an 18-year-old male, admitted for the evaluation of right knee pain. The right knee pain had started 6 months prior without any apparent cause, which was notably severe at night, affecting sleep, and was exacerbated while climbing stairs or bearing weight. The patient also experienced pain on flexion. Three-dimensional computed tomography and magnetic resonance imaging revealed a nodular lesion beneath the cortical bone of the posterior medial plateau of the right tibia and an abnormal signal focus on the posterior lateral aspect of the right tibial plateau associated with extensive bone marrow edema. A small amount of fluid was present in the right knee joint capsule. The patient subsequently underwent arthroscopic excision of the OO. Postoperatively, there was significant relief of pain, and the knee range of motion returned to normal.

CONCLUSION

Although OO in the posterior proximal tibia is a rare occurrence, it can be effectively excised through minimally invasive arthroscopic visualization.

摘要

背景

骨样骨瘤(OO)是一种良性病变,其特征是骨髓中纤维成分增加,骨髓腔内存在骨样结构,以及周围硬化性骨缘。位于胫骨后近端的 OO 报道较少。

病例总结

本文报告了 1 例 18 岁男性患者,因右膝疼痛就诊。右膝疼痛始于 6 个月前,无明显诱因,夜间疼痛明显,影响睡眠,爬楼梯或负重时加重,膝关节屈曲时也疼痛。三维 CT 和磁共振成像显示右胫骨后内侧平台皮质下有结节状病变,胫骨平台后外侧有异常信号焦点,伴有广泛骨髓水肿。右膝关节囊内有少量积液。随后,患者接受了 OO 的关节镜下切除术。术后疼痛明显缓解,膝关节活动度恢复正常。

结论

虽然胫骨后近端的 OO 很少见,但通过微创关节镜可视化可以有效切除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f54b/10843490/02fc1288d472/medi-103-e37076-g001.jpg

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