左膝关节绒毛结节性滑膜炎病一例报道

A case report of pigmented villous nodular synovitis in the left knee

绒毛结节性滑膜炎是一种罕见的,破坏性的纤维组织细胞增生性滑膜性病变,发病机制尚不明确,早期多为关节部位的疼痛与肿胀,晚期可出现关节交锁,活动受限,因缺乏特异性表现,易漏诊误诊,且治疗后复发率极高。本文报道1例陕西中医药大学附属医院2019年11月30日收治病例,给予患者左膝关节滑膜切开探查清理术联合术后放射治疗,术后随访3月余未见复发。由此得出以下结论:绒毛结节性滑膜炎发病率低,临床表现缺乏特异性,易漏诊误诊,MRI可作定性诊断,病理检查为诊断的金标准,病变滑膜切除术联合放射治疗为目前较为成熟的诊疗方案,但术后易复发,因此术后放疗及定期随访对疾病预后极其重要。

Pigmented villous nodular synovitis is a rare,destructive fibrous tissue cell proliferative synovial lesion.The pathogenesis is not yet clear.Most of them are joint pain and swelling in the early stage,and joint interlocking and limited activity can occur in the late stage.Due to lack of specific performance,easy to miss the diagnosis and misdiagnosis,and the recurrence rate after treatment is extremely high.The atticle will report here a case admitted to the Affiliated Hospital of Shaanxi University of Chinese Medicine on November 30,2019.The patient was given synovial incision and exploratory cleaning of the left knee combined with postoperative radiotherapy,and no recurrence was observed for more than three months.The following conclusions are drawn:low incidence of villous nodular synovitis,lack of specific clinical manifestations,easy to miss diagnosis and misdiagnosis,MRI can be used for qualitative diagnosis,pathological examination is the gold standard for diagnosis,and disease synovectomy combined with radiotherapy is a relatively mature diagnosis and treatment plan,but it is easy to relapse after surgery,so postoperative radiotherapy and regular follow-up are extremely important for the prognosis of the disease.