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中华关节外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (03) : 448 -450. doi: 10.3877/cma.j.issn.1674-134X.2023.03.024

个案报道

1例Pellegrini-Stieda病的治疗报道
范冰洋, 袁凌伟, 何海溶, 谢斌, 吴锦秋()   
  1. 730000 兰州,甘肃中医药大学;730000 兰州,甘肃省中医院运动医学科
    730000 兰州,甘肃省中医院运动医学科
  • 收稿日期:2023-02-17 出版日期:2023-06-01
  • 通信作者: 吴锦秋

Case report on treatment of Pellegrini Stieda disease

Bingyang Fan, Lingwei Yuan, Hairong He   

  • Received:2023-02-17 Published:2023-06-01
引用本文:

范冰洋, 袁凌伟, 何海溶, 谢斌, 吴锦秋. 1例Pellegrini-Stieda病的治疗报道[J]. 中华关节外科杂志(电子版), 2023, 17(03): 448-450.

Bingyang Fan, Lingwei Yuan, Hairong He. Case report on treatment of Pellegrini Stieda disease[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(03): 448-450.

Pellegrini-Stieda病(PS病)最先是在20世纪早期被意大利和德国外科医生Augusto Pellegrini and Alfred Stieda提出的,在国内尚无报道。本文通过报道1例PS病例,从发病原因,治疗经过,影像学,病理检查等角度分析该病的发病、治疗情况,也是国内最早报道关于Pellegrini-Stieda病的手术治疗,并首次通过病理切片分析病理表现。

图1 右膝手术前正侧位X线片。图A为右膝关节侧位片,箭头示股骨内髁后方骨化;图B为右膝关节正位片,箭头示股骨内髁周围骨化
图2 手术前右膝关节MRI图像。图A为轴位MRI,箭头示股骨内髁内侧副韧带止点前后,大量骨化组织;图B为冠状位MRI,箭头示膝关节内侧副韧带股骨止点上下大量骨化组织
图3 手术前右膝关节CT图像。图A为CT平扫,示股骨内髁可见大片异常骨性组织,累及内侧髌骨韧带止点;图B为CT三维重建右膝关节,示股骨内髁处可见大片骨质,覆盖整个股骨内髁及周围,接近股骨内髁前、后、下软骨面
图4 右膝手术前关节活动度,示术前右膝关节伸直、屈曲角度
图5 右膝术中病灶及术后病理。图A为术中见股骨内髁大片骨化组织;图B为术中切除的骨化组织;图C为切除组织的HE染色病理切片,×40,可见多灶粘液样变性、钙盐沉积及骨化,骨小梁粗细不一、相互吻合,骨小梁间为疏松的纤维结缔组织,并可见软骨化生及骨化
图6 手术后右膝关节正侧位X线片。图A为正位片,示内侧骨性组织完全切除;图B为侧位片,示股骨内髁后方骨性组织完全切除
图7 右膝术中关节镜松解后被动屈曲角度
图8 右膝手术后关节活动度。图A为术后1周右膝被动屈膝角度;图B为术后4个月右膝主动屈膝角度;图C为术后1年右膝关节伸直、屈曲角度
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