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中华关节外科杂志(电子版) ›› 2024, Vol. 18 ›› Issue (04) : 558 -560. doi: 10.3877/cma.j.issn.1674-134X.2024.04.017

个案报道

急性钙化性腕关节周围炎1例并文献复习
王志彬1, 丁杰1,(), 陈根1, 冯学会1, 王峥1, 解强1   
  1. 1. 100061 北京,国家体育总局运动医学研究所体育医院
  • 收稿日期:2024-01-31 出版日期:2024-08-01
  • 通信作者: 丁杰

Case report and literature review on acute calcific peritendinitis of the wrist

Zhibin Wang, Jie Ding(), Gen Chen   

  • Received:2024-01-31 Published:2024-08-01
  • Corresponding author: Jie Ding
引用本文:

王志彬, 丁杰, 陈根, 冯学会, 王峥, 解强. 急性钙化性腕关节周围炎1例并文献复习[J]. 中华关节外科杂志(电子版), 2024, 18(04): 558-560.

Zhibin Wang, Jie Ding, Gen Chen. Case report and literature review on acute calcific peritendinitis of the wrist[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2024, 18(04): 558-560.

急性钙沉积性疾病(acute calcium deposits,ACD)在临床并不少见,当钙沉积位于关节周围区域,则称为急性钙化性关节周围炎(acute calcific periarthritis,ACP);如果钙结晶存在于肌腱内,则称为急性钙化性肌腱炎(acute calcific peritendinitis,ACT)。ACT临床好发于肩及髋等大关节。手部及腕关节相对报道较少(),且初次就诊时极容易被误诊。最常见的腕部钙化性肌腱炎好发于尺侧腕屈肌(flexor carpi ulnaris tendon,FCU)。掌指关节是手指中最常发病的关节,其次是近端指间关节。目前手腕部ACD国内仅有3例个案报道。本文回顾分析1例腕关节钙化性关节周围炎的诊治经过,并进行相关文献回顾,以期加深对腕部钙化性关节周围炎的认识。

表1 已发表的腕关节及手部各关节ACT/ACP 文献报道总结
图1 术前患者左侧腕关节X线片。图A正位片箭头示左腕尺侧关节可见钙化影;图B为侧位片未见明显异常
图2 术前及术后患者左腕关节CT轴位片。图A箭头示椭圆区域内为钙化灶在腕尺关节FCU(尺侧腕屈肌)深面、关节囊外区域内;图B箭头示术后钙化灶大部分已清除
图3 术前及术后左腕CT三维重建图。图A箭头示术前钙化灶位于尺腕关节周围;图B示术后钙化灶大部分已清除
图4 左腕病灶清除术中前后对比图。图A示术中暴露钙化灶,伤口内可见白色钙化组织,呈牙膏状,周围无明显肌腱组织毗邻;图B示病灶基本清除
图5 术后6周随访患者腕关节功能恢复大体观,示左右腕关节旋转及背伸角度基本一致,功能恢复良好
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