- 期刊
Pigmented Villonodular Synovitis in a 63-year-old Adult: A Case Report
老年色素絨毛結節滑液膜炎病例報告
摘要
色素絨毛結節滑液膜炎是一種罕見的增生性良性關節病變，通常發生於年輕人或中年人。我們報告一個63歲男性個案，初始表現為急性右膝腫脹無力。他在接受保守性症狀治療無效之後，才經由核磁共振檢查診斷出色素絨毛結節滑液膜炎。個案在接受第一次膝關節鏡清除手術後，關節腫脹仍持續並有許多滲出液。第二次開放性滑液膜全切除術後關節症狀終於緩解，但由於長期靜止不動造成右大腿萎縮無力，他被迫進行為期一年的復健才能自由行動。色素絨毛結節滑液膜炎是一種通常發生於中壯年的罕見關節病變，此種疾病若發生在年長者身上容易與其他關節疾患混淆以致延誤治療。此外，年長者術後功能回復也可能較一般人來得差。早期診斷治療以及後續復健，對於良好預後以及術後日常生活功能的維持甚為重要。
並列摘要
Pigmented villonodular synovitis (PVNS) is a rare proliferative disease of the synovium, most commonly seen in young and middle-aged adults. We report a 63-year-old man presenting an acute onset of swelling, a feeling of tightness in the right knee, and difficulty in squatting and standing from squatting position. The patient received conservative treatment, which was ineffective. Subsequent magnetic resonance imaging results led to a diagnosis of PVNS, and extensive arthroscopic synovectomy was performed but recurrent knee swelling developed gradually since the following month. The symptoms eventually subsided after a second arthrotomy followed by total synovectomy. However, the patient suffered from consequent atrophy of quadriceps muscles after months of immobility. He received regular rehabilitation until he could walk without a cane one year later. PVNS is a rare disease commonly seen in young or middle-aged adults; when occurring in an elderly patient, it can be easily neglected or confused with other joint conditions. Although favorable in general, local control rates and functional outcomes of PVNS could be far less desirable in older adults. Early diagnosis, intervention, and rehabilitation are important to achieve better functional outcomes.