股骨头滑膜软骨瘤

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2013-10-14 15:30:54 | 浏览：840

您好，我最近通过三维ct检查出了右侧股骨颈周围多个小结节高密度灶，部分位于髋关节间隙内，医院诊断为滑膜软骨瘤，去年十一月份到今年四月份期间做过三次磁共振，都说的是髋关节积液，是不是现在发展为软骨瘤，还是之前误诊了？请问这个病可否手术，手术后复发几率大不？

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吴超英医生回复发表于 2013-10-15 00:33:14

您好，原发性滑膜骨软骨瘤病(Synovial Chondromatosis)又称滑膜软骨化生，目前病因尚未明确，可能与外伤有关，属良性关节内病变。滑膜增生后形成许许多多的软骨结节，当其脱落于关节腔之内钙化、骨化后即成为关节内游离体。X片上可见关节腔内有散在的钙化或骨化影，早期MRI可确诊，晚期X片上可有骨性关节炎的表现。临床症状为受累关节肿胀、疼痛及压痛，关节穿刺可抽出积液。关节活动时有响声、绞锁征，活动受限。
治疗：切开或关节镜下摘除关节内的游离体，同时必须彻底切除病变的滑膜组织。髋关节滑膜软骨瘤病，是关节镜手术最合适的指征，也是最能体现关节镜治疗优势的病种。因为滑膜软骨瘤病会产生很多游离体，开放手术有的时候，因解剖位置深在，寻找困难。而且开放手术难以处理根本的滑膜问题。而关节镜手术因关节镜本身有放大作用，因此视野清晰广泛、创伤小并同时处理病变滑膜，疗效较好。但是手术后复发几率还是不小，这点你要有心理准备。建议你到正规医院骨科检查后再定是否手术。祝你早日康复。

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吴超英 | 向该医生提问

厦门市第二医院 - 主任医师

张亦工医生回复发表于 2013-10-16 15:07:26

您好：首先我要纠正您的错误，您的病叫“滑膜软骨瘤病”，不是“滑膜软骨瘤”，更不叫“软骨瘤”。因为滑膜软骨瘤病是增生性疾病不是肿瘤，而软骨瘤是肿瘤，将来有可能恶化。滑膜软骨瘤病如果没有症状是可以不用理睬它，而软骨瘤一定要处理它以防发展。所以没有什么“误诊”之说。如果您有症状就可以做关节镜手术。

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张亦工 | 向该医生提问

厦门大学附属第一医院思明分院 - 主任医师

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股骨头滑膜软骨瘤

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