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中华肩肘外科电子杂志 ›› 2023, Vol. 11 ›› Issue (02) : 170 -174. doi: 10.3877/cma.j.issn.2095-5790.2023.02.014

病例报告

右肘关节关节腔外焦磷酸钙沉积病一例
陈景杨, 张会良, 洪泽鑫, 陈诚霖, 刘卓华, 吴宇峰, 陈亮, 蔡亮()   
  1. 528400 广州中医药大学附属中山中医院研究生
    528400 中山市中医院骨三科
  • 收稿日期:2023-04-11 出版日期:2023-05-05
  • 通信作者: 蔡亮
  • 基金资助:
    2021年度广东省基础与应用基础研究基金企业联合基金(2021A1515 220133); 广东省医学科研基金项目(B2022100); 中山市科学技术局中山市社会公益与基础研究项目(2020SYF03)
  • Received:2023-04-11 Published:2023-05-05
引用本文:

陈景杨, 张会良, 洪泽鑫, 陈诚霖, 刘卓华, 吴宇峰, 陈亮, 蔡亮. 右肘关节关节腔外焦磷酸钙沉积病一例[J]. 中华肩肘外科电子杂志, 2023, 11(02): 170-174.

Neame等[1]报道焦磷酸钙沉积病(calcium pyrophosphate deposition disease,CPPD)在50岁以下人群中较少发病,该病最常累及的关节是膝关节、腕关节,少数可发生多关节受累,在年轻患者肘关节周围发生CPPD并不多见。现就工作中发现的1例肘关节关节腔外结节性CPPD进行报道。

图1 患者女性,27岁 图A-C:右侧肘关节外侧见一凸起肿物,长径3.5 cm,短径3.0 cm;图D-E:患者肘关节屈曲范围30°~110°
图2 患者术前影像学检查,右肘关节周围软组织内可见多发团块状高密度影呈菜花状改变 图A-B:X光检查;图C-D:CT三维重建;图E-F:MRI检查
图3 术中取出大量白色不规则肿物,质地较硬,最大者大小4 cm×3 cm×1 cm
表1 术前部分实验室检查
图4 术后复查X光检查肘关节周围团块状高密度影较前大部清除,周围仍见少许结节状增密影 图A:右肘关节侧位片;图B:右肘关节正位片
图5 病理结果显示考虑CPPD表现 图A-C:镜下见纤维间质内见均染无定形物质沉积,见团块状紫蓝色钙化结晶体;图D:肉眼见灰白土黄色组织1堆注:CPPD为焦磷酸钙沉积病
图6 术后3个月患者肘关节屈伸活动范围0°~135° 图A:右肘关节伸直活动达0°;图B:右肘关节屈曲活动达135°
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