关节镜下治疗左肩关节米粒体滑囊炎一例报告  

Application of arthroscopic technique in rice body formation in subacromial-subdeltoid bursitis:a case report

作　　者：唐宇靖 樊守刚[2] 兰海[2] 李开南[2] 李春燕 TANG Yu-jing;FAN Shou-gang;LAN Hai;LI Kai-nan;LI Chun-yan(Zunyi Medical University Graduate School,Guizhou,563000,China)

机构地区：[1]遵义医科大学研究生院,贵州省563000 [2]成都大学附属医院骨科,四川省610000

出　　处：《中国骨与关节杂志》2023年第10期768-770,共3页Chinese Journal of Bone and Joint

摘　　要：米粒体最早由Riese[1]在1例膝关节结核患者的滑液中发现并报道,其本质是一种蛋白质物质,其外观和大小类似于精白米颗粒,因此命名为“米粒体”,在组织病理学检查中,这些米粒体由纤维蛋白制成的小体或薄纤维蛋白层包裹胶原蛋白核组成[2]。米粒体滑囊炎是临床罕见疾病,一般见于风湿病或肺结核引起的慢性滑膜炎,其中最常见的是继发于类风湿性关节炎[3-4]。2022年8月,我院收治1例,现报道如下。Objective To summarize the clinical characteristics of a patient with rice body bursitis(RBS) treated at our instituition,and to report the surgical treatment.Methods Clinical imaging,histopathological,and surgical data were analyzed combined with literature.Results RBS located in the shoulder joint.Cross-sectional T1and T2-weighted magnetic resonance imaging of left shoulder joint showed diffused granules of low signal in the joint capsule.Laboratory tests showed increased levels of rheumatoid factor,anti-cyclic citrullinated peptide antibody,C-reactive protein and erythrocyte sedimentation rate.Arthroscopic exploration of the left shoulder joint was performed and the patient then underwent subdeltoid bursectomy with the removal of rice bodies.The postoperative pathology report indicated chronic inflammation with acute inflammatory changes,which was consistent with the characteristics of chronic bursitis.Conclusions The pathogenesis of RBS remains elusive and its diagnosis is mainly based on MRI,surgical flndings and pathologic examination.Arthroscopic surgery is recommended.Follow-up is essential for recurrence prevention.

关 键 词：肩关节 滑囊炎 磁共振成像 关节炎 类风湿 关节镜 米粒体 

分 类 号：R684.3[医药卫生—骨科学]