腕关节骨内腱鞘囊肿的诊断与治疗  

Intraosseous ganglion of the wrist:diagnosis and management

作　　者：陈山林[1] 田光磊[1] 胡溱[1] 田文[1] 朱瑾[1] 栗鹏程[1] 郜永斌[1] 程晓光[2] 

机构地区：[1]北京积水潭医院手外科 [2]北京积水潭医院放射科

出　　处：《中华骨科杂志》2003年第5期279-282,共4页Chinese Journal of Orthopaedics

摘　　要：目的探讨腕关节骨内腱鞘囊肿的临床特点和治疗方法.方法1993年6月～2002年3月,收治11例腕关节骨内肿物患者,经手术证实为骨内腱鞘囊肿.总结该病的临床症状及影像学特点,并回顾性分析性别、年龄及生长部位等因素与发病的关系.所有患者术后均获得随访,随访时间3～62个月,平均38个月.结果腕关节骨内腱鞘囊肿好发于青壮年,男女比例为3:8,多为优势手发病,占72.7%.主要症状为腕关节疼痛,病程2～84个月.X线特点为腕骨内出现密度减低区,周围有硬化缘.CT及MR检查提示病灶内为密度均匀的液体.11例患者均接受手术治疗,术后8例疼痛消失,2例有轻度疼痛,但功能正常,另外1例无明显改善.结论腕关节骨内腱鞘囊肿的诊断依赖于临床症状及影像学表现,确诊须依据术中所见及病理结果.手术治疗效果满意.Objective To introduce the clinical characteristics and management of intraosseous ganglion of wrist. Methods Eleven cases of carpal bone cystic lesions were treated from June 1993 to March 2002. All of them were proved to be intraosseous ganglion. The symptoms and imaging characteristics were summarized retrospectively. The relationships between the age, gender and some other factors of the patients with the incidence of the disease were analysed. All of the patients were followed up from 3 to 62 months after operation. Results Almost all of the patients were of young and middle aged people. There were 3 males and 8 females. The lesion most likely occurred in the dominant hand(72.7%). The main symptom of wrist intraosseous ganglion was pain, the average duration of symptoms was 2-84 months. X-rays showed a translucent area with a thin sclerotic margin within the carpal bone. CT scanning and MRI demonstrated it was liquid in content. After operation, 8 patients obtained an excellent result with no pain and normal function, 2 good with mild discomfort and one poor with no improvement. Conclusion Although intraosseous ganglion of wrist is a rare disease, it has some basic clinical characteristics. It is diagnosed according to its symptoms and imaging manifestations, and is confirmed by the operative findings and pathologic examination. Surgical treatment usually achieves satisfactory results.

关 键 词：腕关节 骨内腱鞘囊肿 CT MR检查 影像学诊断 病理学 

分 类 号：R686.1[医药卫生—骨科学]