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髋关节滑膜囊肿病因及诊断的回顾性分析
Hits: 3137   Download times: 1554   Received:April 20, 2009    
作者Author单位UnitE-Mail
王立峰 WANG Li-feng 浙江大学医学院附属第一医院骨科,浙江 杭州 310003 Department of Orthopaedics,the First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,Zhejiang,China  
徐三中 XU San-zhong 浙江大学医学院附属第一医院骨科,浙江 杭州 310003 Department of Orthopaedics,the First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,Zhejiang,China  
林向进 LIN Xiang-jin 浙江大学医学院附属第一医院骨科,浙江 杭州 310003 Department of Orthopaedics,the First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,Zhejiang,China  
期刊信息:《中国骨伤》2010年23卷,第4期,第271-274页
DOI:10.3969/j.issn.1003-0034.2010.04.011


目的:探讨髋关节滑膜囊肿的常见病因和早期、经济有效的诊断方法。

方法:自1999年至2007年,收治4例髋关节滑膜囊肿,自1978到2002的文献中,用关键词“髋关节”、“滑膜囊肿”在中国知网上(CNKI)检索到1例,用关键词“synovial cyst”和“hip”在美国医学索引(Medline)上检索到20例。25例髋关节滑膜囊肿患者,男16例,女9例,年龄14~76岁,平均52.8岁。临床主要表现为腹股沟中点内侧无痛性包块及下肢静脉功能不全。采用超声、CT、MRI诊断,对25例患者的病因、临床表现及影像学检查等进行回顾性分析。

结果:25例髋关节滑膜囊肿的病因,原因不明者9例,类风湿性关节炎8例,人工关节置换术后3例,外伤2例,股骨头坏死2例,骨关节炎1例。常见症状有腹股沟区无痛性肿块9例,下肢静脉功能不全7例,腹股沟区局部软组织肿胀5例,深静脉血栓3例,股动脉受压1例。手术前经超声(多普勒)确诊13例,超声+CT检查确诊8例,超声+CT+MRI检查确诊2例,经髋关节腔造影确诊1例,经局部囊肿穿刺造影确诊1例。

结论:髋关节滑膜囊肿发病率低,起病隐匿,常由髋关节慢性炎症引起,诊断常被延误,并发症严重,应引起重视。彩色超声多普勒是一种早期、经济有效的诊断方法。
[关键词]:髋关节  滑膜囊肿  超声检查,多普勒
 
A review of diagnosis and causes of synovial cyst of the hip joint
Abstract:

Objective: To analyze the clinical and radiological characteristics of hip joint synovial cyst,and to study the main causes and the early economical effective ways for diagnosis.

Methods: Twenty-five patients with hip joint synovial cyst were studied in this research,including 16 males and 9 females aged from 14 to 76 with an average age of 52.8 years old(4 cases from clinical treatment from 1999 to 2007;1 case searched with keyword“synovial cyst” and “hip” on CNKI form 1978 to 2002,20 cases searched with keyword synovial cyst and hip on the Medline. The clinical manifestation of 25 cases were painless mass at medial of groin middle point and lower limb venous insufficiency. Synovial cysts of the hip joint were diagnosed by ultrasonography,computer tomography(CT) or nuclear magnetic resonance (MRI). All cases were analyzed retrospectively on the cause of a diseace,clinical features and radiological examinations.

Results: The possible causes of this disease included rheumatoid arthritis in 8 cases,osteoarthritis in 1,total hip replacement in 3,hip tramatic in 3,femoral head necrosis in 2 and unknown origin in 9. The main clinical features included painless groin mass in 9 cases;compression of the common femoral and external iliac veins(lead to outflow obstruction and leg swelling) in 7 cases;inguinal swelling in 5 cases;deep vein thrombosis (DVT) in 3 cases;compression of artery in 1 case. The correct preoperative diagnosis were made by ultrasonography or combined with colour duplex doppler ultrasonography(CDDS) in 13 cases;CDDS combined with CT in 8 cases;CDDS combined with CT and MRI in 2 cases;articular cavity visualization in 1 case;puncture herniography in 1 case.

Conclusion: The hip joint synovial cyst is mainly caused by the chronic inflammation of the hip joint. As the disease is extremely rare and asymptomatically,precise diagnoses are difficult and and often delayed. More attentions should be paid because of its severe complications. CDDS is an economical effective way for early diagnosis.
KEYWORDS:Hip joint  Synovial cyst  Ultrasonography,doppler
 
引用本文,请按以下格式著录参考文献:
中文格式:王立峰,徐三中,林向进.髋关节滑膜囊肿病因及诊断的回顾性分析[J].中国骨伤,2010,23(4):271~274
英文格式:WANG Li-feng,XU San-zhong,LIN Xiang-jin.A review of diagnosis and causes of synovial cyst of the hip joint[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(4):271~274
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