Sherafatvaziri Arash, Vosoughi Fardis, Mirzamohamadi Alireza, Nejad Erfan Babaei, Shayan-Moghadam Ramin
Department of Orthopedic Surgery, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Orthopedic and Trauma Surgery, Center for Orthopedics Trans-Disciplinary Applied Research, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Int J Surg Case Rep. 2024 Jun;119:109705. doi: 10.1016/j.ijscr.2024.109705. Epub 2024 Apr 25.
Plicae or synovial folds can be detected in different joints, especially around the knee. Synovial plicae pathologies are rare conditions with difficulty in diagnosis because of various symptoms overlapping with other diseases.
We reported a rare case of symptomatic hypertrophic synovial plica in the lateral side of the knee in a 12-year-old boy following a traumatic event almost two years before the surgery. The diagnosis and treatment were conducted by knee arthroscopy, and follow-up of the patients showed significant improvements with no pain or range of motion restrictions.
The reported case had a significantly lower age of presentations compared to most previously reported cases, and he was diagnosed with lateral knee hypertrophic plicae, while medial knee hypertrophic plicae are more commonly reported, which is considered rare findings. Contrary to previous studies of lateral plica, our case had a history of significant direct trauma, and he was not a professional athlete. Furthermore, based on evidence, hypertrophic synovial plicae are mostly asymptomatic, but in our case, there was a pain in his knee that worsened in flexion.
Physicians should consider the possibility of synovial hypertrophic plicae, especially in younger patients with histories of direct traumatic events.
滑膜皱襞可在不同关节中发现，尤其是膝关节周围。滑膜皱襞病变较为罕见，由于其各种症状与其他疾病重叠，诊断存在困难。
我们报告了一例罕见病例，一名12岁男孩在手术前近两年因外伤导致膝关节外侧出现有症状的肥厚性滑膜皱襞。通过膝关节镜进行诊断和治疗，患者随访显示有显著改善，无疼痛或活动范围受限。
与大多数先前报道的病例相比，该病例的发病年龄明显更低，他被诊断为膝关节外侧肥厚性皱襞，而膝关节内侧肥厚性皱襞报道更为常见，这被认为是罕见发现。与先前关于外侧皱襞的研究相反，我们的病例有明显的直接外伤史，且他并非职业运动员。此外，根据证据，肥厚性滑膜皱襞大多无症状，但在我们的病例中，他的膝关节疼痛，屈曲时加重。
医生应考虑滑膜肥厚性皱襞的可能性，尤其是在有直接外伤史的年轻患者中。
