关节疼痛

［Objective］To explore the technique of arthroscopy plus radiotherapy in the treatment of pigmented villonodular synovitis of the knee and to evaluate its clinical value［Method］A total of 14 cases of pigmented villonodular synovitis of the knee were treated from January 2000 to July 2003Intraarticular excision under arthroscope with a combined application of routine intrusments and Bipolar radiofrequency was performed on all these 14 cases,and postoperative radiotherapy for diffused pigmented villonodular synovitis of the knee,13 patients were followed up for 10~45 months,and were evaluated for range of motion,pain,swelling effusion［Result］Thirteen cases according to the International Knee Documentation Committeecriteria,subjective knee score was (587+64) and (865 ±57) respectively before surgery and at the last followup［Conclusion］In case of pigmented villonodular synovitis of the knee joint,arthroscopical synovectomy can make good surgical results,and postoperative radiotherapy is an effective treatment for diffused pigmented vilionoclular synovitis of the knee

作者：王晓旭，廖瑛，黄华扬，席雅文，李朝旭，韩志关节镜；放射治疗；膝关节；滑膜炎；色素绒毛结节性摘要：［目的］探讨采用关节镜结合放射治疗膝关节色素沉着绒毛结节性滑膜炎的方法及其临床应用价值。［方法］2000年1月～2003年7月，共收治14例膝关节色素沉着绒毛结节性滑膜炎患者，采用关节镜下常规器械加双极射频进行关节内病变切除，术后弥漫性色素沉着绒毛结节性滑膜炎辅以放疗，13例通过10~45个月的随访，了解患膝活动度、疼痛、肿胀情况。［结果］13例随访患者，术前国际膝关节评分委员会膝关节功能主观评分为（587±64）分，最后随访时，IKDC膝关节功能主观评分为（865±57）分。［结论］通过关节镜能完成膝关节色素沉着绒毛结节性滑膜炎滑膜较彻底切除，对弥漫性膝关节色素沉着绒毛结节性滑膜炎辅以术后放疗是一种有效方法。

Infections of 3 cases were controled after treatment with the wound dressing and compression bandaging after local inflammation organic resection, oral Xinhuang Tablets of proprietary Chinese medicines and antibiotics; 9 cases were treated with arthroscopic joint clean-up washing , 2 case of them were treated with incision debridement combined by synovectomy arthroscopic due to inability to complete debridement ; 3 case of them were treated with temporary prosthesis replacement surgery on the infection after total knee debridement due to recurring knee swelling and rupture , filling bone cement containing sensitive antibiotics, convection to wash on the articular cavity, and second phase renovation in stable condition, finally they recoveried postoperatively and discharged.

结果：对22例出现炎症性反应的TKA术后患者，经抗感染、关节腔对流冲洗、清创和Ⅱ期再置换并配合口服中成药新癀片等处理。10例轻微肿痛病人经单纯药物治疗，症状改善。12例患者应用外科干预， 3例行局部炎症组织切除后伤口换药并加压包扎，口服中成药新癀片及抗生素治疗后控制感染；9例在关节镜下行关节清理冲洗，其中2例在行关节镜下手术时因无法彻底清创行切开清创合并滑膜切除； 3例因反复出现膝关节红肿、疼痛、甚至破溃予全膝置换术后感染清创临时假体置换术，用含敏感抗生素骨水泥填充，对关节腔进行对流冲洗，待关节情况稳定后行Ⅱ期翻修，术后痊愈出院。

These include inflammatory arthritides such as rheumatoid arthritis, ankylosing spondylitis and reactive arthritis,99 101 synovial impingement,meniscoid entrapment, chondromalacia facetae, pseudogout,synovial inflammation, villonodular synovitis, and acute and chronic infection.102 106 Intrafacetal synovial cysts can be a source of pain because of distension and pressure on adjacent pain-generating structures, calcification,and asymmetrical facet hypertrophy.107 110 In a retrospective review of MRI scans in 303 consecutive patients with LBP, Doyle and Merrilees111 found that9.5% had facet joint synovial cysts, the large majority of which were located posteriorly.

包括炎症性关节炎如类风湿性关节炎，强直性脊柱炎及反应性关节炎等，还有滑液撞击，关节软骨版卡压，关节面软骨软化，假性痛风，滑液炎症，绒毛结节性滑膜炎和急慢性感染。小关节内滑囊囊肿可由于拉伸和压缩临近的疼痛发生结构，骨化及不对称关节增生等原因引起疼痛。在一项303例连续患者的MRI研究中，Doyle 和 Merrilees发现其中9.5%存在小关节囊肿，大部分发生于关节囊后部。

University of California analyzed more than 100 studies and found around 1/3 veterans in 1999 war experienced fatigue, muscle or joint pain, memory and sleep problems, rushers and breathing troubles.

加里福尼亚大学分析了100多项研究，发现参加过1999年海湾战争的退役士兵中，大约有三分之一出现了疲倦，肌肉或关节疼痛，记忆及睡眠出现问题，出疹和呼吸道疾病。

Apart from the affected gland function, some patients have mild, self-limited joint pain, as well as vasculitis, peripheral neuritis, such as pulmonary fibrosis performance.

除腺体功能受影响外，部分病人还有轻度、自限性关节疼痛，以及血管炎、周围神经炎、肺纤维化等表现。

If you've suffered anxiety, headaches, or muscle or joint pain, you might already be familiar with wild lettuce.

如果你曾经遭受过焦虑、头痛、肌肉或关节疼痛的症状，你也许已经熟悉了野莴苣。

The tsetse fly bite erupts into a red sore and within a few weeks the person can experience fever, swollen lymph glands, aching muscles and joints, headaches and irritability.

采采蝇叮咬出现红肿，并且在几周内患者可伴有发烧、淋巴腺肿大、肌肉和关节疼痛、头痛和易怒。

Stinging nettle has historically been used for joint pain.

荨麻历来被用于关节疼痛。

Common pulmonary signs have joint pain or hypertrophy, clubbing, multiple neuritis, myasthenia gravis, Cushing's disease, male breast hypertrophy, hypercalcemia, mental disorders.

肺外体征常见有四肢关节疼痛或肥大、杵状指，多发性神经炎，重症肌无力，库欣病、男性乳房增生肥大、高钙血症、精神异常等。

Extrapulmonary signs common with limb joint pain or enlargement, clubbing, multiple neuritis, myasthenia gravis, Cushing's disease, male breast hypertrophy, hypercalcemia, mental disorders.

肺外体征常见有四肢关节疼痛或肥大、杵状指，多发性神经炎，重症肌无力，库欣病、男性乳房增生肥大、高钙血症、精神异常等。

Breath, muscle contraction of the buttocks; arch body, as far as possible to hold his head, right leg straight towards the ceiling (peg-leg knee in order to avoid muscle tension).

呼气，收缩臀部肌肉；拱起身体，尽量抬起头来，右腿伸直朝向天花板（膝微屈，以避免肌肉紧张）。

The cost of moving grain food products was unchanged from May, but year over year are up 8%.

粮食产品的运输费用与5月份相比没有变化，但却比去年同期高8％。