Mukand J, Sniger W, Kaufman J, Biener-Bergman S
Southern New England Rehabilitation Center, Providence, Rhode Island 02907, USA.
Am J Phys Med Rehabil. 1998 Mar-Apr;77(2):113-7.
Patients with spinal cord injury are predisposed to knee effusions owing to osteoporosis, heterotopic ossification, trauma, and benign hydrarthrosis. This retrospective review discusses 11 patients with spinal cord injury and knee effusions seen during two years. One objective is to correlate the initial diagnosis based on clinical findings with the final diagnosis based on synovial fluid analysis and radiographic studies. Another is to describe the variety and complexity of clinical situations that involve knee effusions in spinal cord injury. The initial diagnosis was different from the final diagnosis in all of our cases. The final diagnoses were trauma (6 cases), pseudogout (2 cases), spasticity, fracture of the tibial plateau, septic joint, and tears of the anterior cruciate and lateral collateral ligaments. Knee effusions in this unique population must be carefully investigated to avoid erroneous diagnoses based on the initial clinical presentation, which can be complicated by multiple medical problems.
脊髓损伤患者由于骨质疏松、异位骨化、创伤和良性关节积水而容易出现膝关节积液。本回顾性研究讨论了两年内见到的11例脊髓损伤合并膝关节积液的患者。一个目的是将基于临床表现的初始诊断与基于滑液分析和影像学研究的最终诊断相关联。另一个目的是描述脊髓损伤中涉及膝关节积液的临床情况的多样性和复杂性。在我们所有的病例中，初始诊断与最终诊断不同。最终诊断为创伤（6例）、假性痛风（2例）、痉挛、胫骨平台骨折、化脓性关节炎以及前交叉韧带和外侧副韧带撕裂。对于这一特殊人群的膝关节积液必须进行仔细检查，以避免基于初始临床表现的错误诊断，因为初始临床表现可能因多种医学问题而变得复杂。
