Baker's Cysts in Calcium Pyrophosphate Dihydrate Deposition Disease: A Musculoskeletal Ultrasound Study

貝克氏囊腫在雙氫氧化焦磷酸鈣沈積疾病之臨床表現：骨骼肌肉超音波研究

戴舜邦(Shun-Ban Tai) ； 盧俊吉(Chun-Chi Lu) ； 陳政宏(Chen-Hung Chen) ； 周雨青(Yu-Ching Chou) ； 張棋楨(Chi-Ching Chang)

《內科學誌》 25卷4期 (2014/08) Pp. 281-287

https://doi.org/10.6314/JIMT.2014.25(4).07

摘要

藉由骨骼肌肉超音波，調查雙氫氧化焦磷酸鈣沈積疾病病患中，貝克氏囊腫的臨床表現。對於關節液抽吸分析後，60位診斷為雙氫氧化焦磷酸鈣沈積疾病病患，進行臨床與骨骼肌肉超音波的研究探討。分析貝克氏囊腫與變數如關節積液、滑膜炎、軟骨鈣化及骨刺的關係。藉由骨骼肌肉超音波，我們發現在60個膝關節中有17個（28.3%）貝克氏囊腫。關節積液、滑膜炎、軟骨鈣化及骨刺在膝關節偵測出來的數量（比例）分別是60個（100%）、55個（91.7%）、11個（18.3%）及45個（75.0%）。貝克氏囊腫的存在與否與關節積液、滑膜炎、軟骨鈣化及骨刺無明顯的關連性（p＞0.05）。貝克氏囊腫常見於雙氫氧化焦磷酸鈣沈積疾病的病患中（約28%），而且它們常與關節積液、滑膜炎、軟骨鈣化及骨刺同時出現。貝克氏囊腫在臨床檢查中易被忽略，但是骨骼肌肉超音波可以準確性的診斷。因此，臨床醫師應常用骨骼肌肉超音波來診斷貝克氏囊腫。

並列摘要

To investigate the clinical presentation of Baker's cyst in patients with calcium pyrophosphate dehydrate (CPPD) calcifications of the knee, the most commonly affected site in CPPD deposition disease, with the use of high-resolution musculoskeletal ultrasound (MUS). This was a prospective clinical and MUS study conducted in 60 patients with CPPD deposition disease of the knee. The patients' synovial fluid was aspirated and examined for the identification of crystals. The relationships between the Baker's cyst and occurrence of joint effusion, synovitis, chondrocalcinosis, and osteophytes were analyzed. Baker's cysts were demonstrated by MUS in 17 (28.3%) of the 60 patients. Joint effusion was present in all 60 (100%) patients. In addition, 55 (91.7%) patients had synovitis, 11 (18.3%) had chondrocarcinosis, and 45 (75.0%) had osteophytes. There was no significant correlation between the occurrence of Baker's cyst and the occurrence of effusion, synovitis, chondrocarcinosis, and osteophytes (p＞0.05). These results indicate that Baker's cysts are a common occurrence in patients with CPPD deposition disease, affecting 28% of this population and that they can be accompanied by joint effusion, synovitis, chondrocalcinosis, and osteophytes. Baker's cysts are easily missed on clinical examination without image guidance, but can be accurately identified with the use of MUS. Therefore, MUS should be more widely employed by clinicians in the diagnosis of Baker's cysts.

並列關鍵字

Baker's cyst ； Musculoskeletal ultrasound (MUS) ； Calcium pyrophosphate dehydrate (CPPD)