Yamasaki Yutaro, Maeyama Akira, Takeuchi Mai, Yamamoto Takuaki
Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
J Orthop Case Rep. 2024 Dec;14(12):18-21. doi: 10.13107/jocr.2024.v14.i12.5002.
We experienced a rare case in which a bilateral snapping knee was caused by rheumatoid arthritis accompanied by Sjögren's syndrome (SS), and the symptoms were resolved by arthroscopic surgery.
A 43-year-old Asian male presented at another hospital with finger, shoulder, and knee pain and was diagnosed with rheumatoid arthritis accompanied by SS. Two months later, he developed the snapping phenomenon in both knees and presented at our hospital. The patient was positive for rheumatoid factor, anti-Smith antibody, and anti-SS-A antibody. Arthroscopy revealed a hard scar-like tissue in the lateral patellofemoral joint in both knees. The scar-like tissue was excised arthroscopically. Post-operatively, the snapping phenomenon and pain during flexion of the bilateral knee joints had been resolved.
In the present case, rheumatoid arthritis accompanied by SS caused inflammation of the knee joints and degeneration of the articular capsules, and snapping of the bilateral knees was caused by impingement of the scar tissue in the patellofemoral joints.
我们遇到了一例罕见病例,类风湿关节炎伴干燥综合征(SS)导致双侧膝关节弹响,经关节镜手术症状得以缓解。
一名43岁的亚洲男性因手指、肩部和膝关节疼痛就诊于另一家医院,被诊断为类风湿关节炎伴SS。两个月后,他双膝关节出现弹响现象,并前来我院就诊。患者类风湿因子、抗史密斯抗体和抗SS - A抗体均呈阳性。关节镜检查发现双膝关节外侧髌股关节有坚硬的瘢痕样组织。通过关节镜切除了瘢痕样组织。术后,双侧膝关节的弹响现象及屈曲时的疼痛均已缓解。
在本病例中,类风湿关节炎伴SS导致膝关节炎症和关节囊退变,双侧膝关节弹响是由髌股关节瘢痕组织撞击引起的。