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以腘窝囊肿为表现的色素沉着绒毛结节性滑膜炎1例

2017-11-26 佚名 临床骨科杂志

腘窝囊肿色素沉着滑膜炎
关注

患者，女，51岁，无意中发现右膝后方包块3年余，一直未予以重视，包块渐增大至鸡蛋大小，行走时轻度肿胀感，于2016年4月来我院就诊。

【一般资料】

患者，女，51岁，

【现病史】

无意中发现右膝后方包块3年余，一直未予以重视，包块渐增大至鸡蛋大小，行走时轻度肿胀感，于2016年4月来我院就诊。

【体格检查】

右膝关节无肿胀，皮温不高，右膝关节后内侧可触及一约4.0CM×4.0CM包块，边缘欠清晰，质韧，压痛(+/－)，浮髌实验(－)，右膝关节屈伸活动尚可

【辅助检查】

右膝关节X线片:骨质未见明显异常，关节间隙正常。右膝关节MRI(见图1):腘窝内可见多个囊性长T2信号，其间可见分割；内外侧副韧带、半月板及前后交叉韧带未见异常信号；膝关节后方可见囊状长T2液体信号；关节腔可见结节状等T1、短T2信号，边缘欠清晰。



【初步诊断】

右腘窝囊肿。

【治疗】

在硬膜外麻醉下手术，取右膝关节后方弧形切口，见包块位于腓肠肌内侧头与半膜肌之间，有完整包膜，沿包块周围钝性分离直至根部，见其底部与股骨内髁相连，与关节腔相通，予以完整切除，见包膜内黄褐色液体。稀碘水冲洗创腔，查无活动性出血，逐层缝合切口。切除的标本送病理组织检查，术后病理诊断为色素沉着绒毛结节性滑膜炎(见图2)。

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    2018-09-20 crystal0572

    #结节性#

    0

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    2018-07-15 sunylz

    #色素#

    0

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    2017-11-30 明天会更好！

    学习了.谢谢分享!

    0

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    2017-11-30 明天会更好！

    学习了.谢谢分享!

    0

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    2017-11-28 12498ca5m83暂无昵称

    #囊肿#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1693555, encodeId=cc961693555ff, content=<a href='/topic/show?id=cb16e883013' target=_blank style='color:#2F92EE;'>#结节性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78830, encryptionId=cb16e883013, topicName=结节性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3d8429436174, createdName=crystal0572, createdTime=Thu Sep 20 08:55:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1680470, encodeId=c2ac16804e01a, content=<a href='/topic/show?id=9e5c86e0712' target=_blank style='color:#2F92EE;'>#色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86707, encryptionId=9e5c86e0712, topicName=色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=343027846633, createdName=sunylz, createdTime=Sun Jul 15 04:55:00 CST 2018, time=2018-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265642, encodeId=b45f265642e4, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好！, createdTime=Thu Nov 30 11:22:34 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265641, encodeId=e25b265641a0, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好！, createdTime=Thu Nov 30 11:22:27 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1340760, encodeId=70471340e60ba, content=<a href='/topic/show?id=74a140404de' target=_blank style='color:#2F92EE;'>#囊肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40404, encryptionId=74a140404de, topicName=囊肿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32a12500167, createdName=12498ca5m83暂无昵称, createdTime=Tue Nov 28 00:55:00 CST 2017, time=2017-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379490, encodeId=4a2613e94901e, content=<a href='/topic/show?id=09e46655974' target=_blank style='color:#2F92EE;'>#滑膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66559, encryptionId=09e46655974, topicName=滑膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a98f453, createdName=pcw106, createdTime=Tue Nov 28 00:55:00 CST 2017, time=2017-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=264509, encodeId=3db6264509dd, content=挺好的呀, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/20/02e70d8a81756be978c1ac6ecae73990.jpg, createdBy=a0592196997, createdName=暂20a6e63m, createdTime=Sun Nov 26 14:32:31 CST 2017, time=2017-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=264493, encodeId=44592644932d, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋，懒，贪, createdTime=Sun Nov 26 11:09:57 CST 2017, time=2017-11-26, status=1, ipAttribution=)]
    2017-11-28 pcw106

    #滑膜炎#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1693555, encodeId=cc961693555ff, content=<a href='/topic/show?id=cb16e883013' target=_blank style='color:#2F92EE;'>#结节性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78830, encryptionId=cb16e883013, topicName=结节性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3d8429436174, createdName=crystal0572, createdTime=Thu Sep 20 08:55:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1680470, encodeId=c2ac16804e01a, content=<a href='/topic/show?id=9e5c86e0712' target=_blank style='color:#2F92EE;'>#色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86707, encryptionId=9e5c86e0712, topicName=色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=343027846633, createdName=sunylz, createdTime=Sun Jul 15 04:55:00 CST 2018, time=2018-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265642, encodeId=b45f265642e4, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好！, createdTime=Thu Nov 30 11:22:34 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265641, encodeId=e25b265641a0, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好！, createdTime=Thu Nov 30 11:22:27 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1340760, encodeId=70471340e60ba, content=<a href='/topic/show?id=74a140404de' target=_blank style='color:#2F92EE;'>#囊肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40404, encryptionId=74a140404de, topicName=囊肿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32a12500167, createdName=12498ca5m83暂无昵称, createdTime=Tue Nov 28 00:55:00 CST 2017, time=2017-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379490, encodeId=4a2613e94901e, content=<a href='/topic/show?id=09e46655974' target=_blank style='color:#2F92EE;'>#滑膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66559, encryptionId=09e46655974, topicName=滑膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a98f453, createdName=pcw106, createdTime=Tue Nov 28 00:55:00 CST 2017, time=2017-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=264509, encodeId=3db6264509dd, content=挺好的呀, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/20/02e70d8a81756be978c1ac6ecae73990.jpg, createdBy=a0592196997, createdName=暂20a6e63m, createdTime=Sun Nov 26 14:32:31 CST 2017, time=2017-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=264493, encodeId=44592644932d, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋，懒，贪, createdTime=Sun Nov 26 11:09:57 CST 2017, time=2017-11-26, status=1, ipAttribution=)]
    2017-11-26 暂20a6e63m

    挺好的呀

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1693555, encodeId=cc961693555ff, content=<a href='/topic/show?id=cb16e883013' target=_blank style='color:#2F92EE;'>#结节性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78830, encryptionId=cb16e883013, topicName=结节性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3d8429436174, createdName=crystal0572, createdTime=Thu Sep 20 08:55:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1680470, encodeId=c2ac16804e01a, content=<a href='/topic/show?id=9e5c86e0712' target=_blank style='color:#2F92EE;'>#色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86707, encryptionId=9e5c86e0712, topicName=色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=343027846633, createdName=sunylz, createdTime=Sun Jul 15 04:55:00 CST 2018, time=2018-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265642, encodeId=b45f265642e4, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好！, createdTime=Thu Nov 30 11:22:34 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265641, encodeId=e25b265641a0, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160914/IMG57D82E721DB581755.jpg, createdBy=4fc81933929, createdName=明天会更好！, createdTime=Thu Nov 30 11:22:27 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1340760, encodeId=70471340e60ba, content=<a href='/topic/show?id=74a140404de' target=_blank style='color:#2F92EE;'>#囊肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40404, encryptionId=74a140404de, topicName=囊肿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32a12500167, createdName=12498ca5m83暂无昵称, createdTime=Tue Nov 28 00:55:00 CST 2017, time=2017-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379490, encodeId=4a2613e94901e, content=<a href='/topic/show?id=09e46655974' target=_blank style='color:#2F92EE;'>#滑膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66559, encryptionId=09e46655974, topicName=滑膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a98f453, createdName=pcw106, createdTime=Tue Nov 28 00:55:00 CST 2017, time=2017-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=264509, encodeId=3db6264509dd, content=挺好的呀, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/20/02e70d8a81756be978c1ac6ecae73990.jpg, createdBy=a0592196997, createdName=暂20a6e63m, createdTime=Sun Nov 26 14:32:31 CST 2017, time=2017-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=264493, encodeId=44592644932d, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋，懒，贪, createdTime=Sun Nov 26 11:09:57 CST 2017, time=2017-11-26, status=1, ipAttribution=)]
    2017-11-26 戒馋，懒，贪

    谢谢分享学习了

    0

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