复发性肩峰下米粒体滑囊炎的关节镜治疗及病理特征——附1例报道及文献回顾

doi:10.3969/j.issn.2095-378X.2025.01.004

外科研究与新技术（中英文） ›› 2025, Vol. 14 ›› Issue (1): 18-22.doi: 10.3969/j.issn.2095-378X.2025.01.004

复发性肩峰下米粒体滑囊炎的关节镜治疗及病理特征——附1例报道及文献回顾

尹帮德¹, 程飚¹, 张素霞², 王家骐¹

1.同济大学附属同济医院运动医学科,上海 200065;
2.同济大学附属同济医院病理科,上海 200065

收稿日期:2024-12-11 出版日期:2025-03-28 发布日期:2025-04-09
通讯作者: 王家骐,电子信箱：wjq0117@163.com
作者简介:尹帮德（1998—），男，硕士，住院医师，从事临床关节外科与运动医学科工作
基金资助:
上海市卫生健康委员会科研面上项目（202140286）

Arthroscopic treatment and pathological features of recurrent subacromial rice body bursitis： Report of 1 case and literature review

YIN Bangde¹, CHENG Biao¹, ZHANG Suxia², WANG Jiaqi¹

1. Department of Sports Medicine, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, China;
2. Department of Pathology, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, China

Received:2024-12-11 Online:2025-03-28 Published:2025-04-09

摘要/Abstract

摘要： 目的　通过介绍1例复发性肩峰下米粒体滑囊炎的临床诊治经验、病理特征,结合文献复习,为提高对该病的认知提供参考。方法　收治1例因“右肩关节滑膜软骨瘤”在外院接受右肩关节镜手术后1年余,再发右肩关节肿胀疼痛1个月的中年女性患者,经体检、完善MRI等影像学检查及类风湿因子等实验室检查后初步诊断为右肩关节滑膜软骨瘤病再发,行肩关节镜下游离体取出及滑膜切除术。结果　患者术后胀痛等症状消失,右肩关节恢复正常活动度。术后病理报告提示慢性滑囊炎症和纤维结构游离体,最终诊断为复发性肩峰下米粒体滑囊炎。结论　肩峰下米粒体滑囊炎的发病机制仍未明确,其诊断主要基于MRI、镜下观察和病理检查,关节镜手术是有效的治疗方法,彻底清理和随访是预防复发的关键。

关键词: 肩峰下滑囊炎, 米粒体, 关节镜, 病理特征

Abstract: Objective To summarize the clinical diagnosis and treatment and pathological features of a case with recurrent subacromial rice body bursitis, combined with literature review, and to raise understanding of the disease. Methods A middle-aged female was admitted, who had received arthroscopic surgery on the right shoulder for "synovial chondroma of the right shoulder joint" in another hospital 1 year ago, and suffered from recurrence of swelling and pain in the right shoulder joint for more than 1 month. After physical examination, MRI, and rheumatoid factor assays, the preliminary diagnosis was recurrent synovial chondromatosis of the right shoulder joint. Subsequently,arthroscopic synovectomy and loose body removal were performed. Results The patient's postoperative swelling and pain disappeared, and the range of motion of the right shoulder joint is recovered. Postoperative pathological reports indicated chronic bursitis and fibrous structured loose bodies, leading to the final diagnosis of recurrent subacromial rice body bursitis. Conclusion The pathogenesis of subacromial rice body bursitis remains unclear, and the diagnosis is predominantly reliant on MRI, arthroscopic assessment, and histopathological examination. Arthroscopic surgery is an effective therapeutic approach, with comprehensive debridement and subsequent follow-up essential to prevent recurrence.

Key words: Subacromial bursitis, Rice body, Arthroscopy, Pathological feature

中图分类号:

R686.7

尹帮德, 程飚, 张素霞, 王家骐. 复发性肩峰下米粒体滑囊炎的关节镜治疗及病理特征——附1例报道及文献回顾[J]. 外科研究与新技术（中英文）, 2025, 14(1): 18-22.

YIN Bangde, CHENG Biao, ZHANG Suxia, WANG Jiaqi. Arthroscopic treatment and pathological features of recurrent subacromial rice body bursitis： Report of 1 case and literature review[J]. Surgical Research and New Technique, 2025, 14(1): 18-22.

参考文献

[1] Wu QM, Ha W, He LR, et al.MRI diagnosis of right shoulder-joint rice-body bursitis: A case report[J]. Asian J Surg, 2024, 47(7): 3117-3118.
[2] Guo JJ, Wu K, Xu Y, et al.Hundreds of rice bodies in the subacromial-subdeltoid bursa: report of two cases and literature review[J]. BMC Musculoskel Dis, 2020, 21(1): 539.
[3] Mishra BN, Poudel RR, Jha A, et al.Rheumatoid subacromial-subdeltoid bursitis with rice bodies: A case report[J]. J Clin Orthop Trauma, 2019, 10(3): 514-517.
[4] Chen A, Wong LY, Sheu CY, et al.Distinguishing multiple rice body formation in chronic subacromial-subdeltoid bursitis from synovial chondromatosis[J]. Skeletal Radiol, 2002, 31(2): 119-121.
[5] Forse CL, Mucha BL, Santos MLZ, et al.Rice body formation without rheumatic disease or tuberculosis infection: a case report and literature review[J]. Clin Rheumatol, 2012, 31(12): 1753-1756.
[6] Tan CHA, Rai SB, Chandy J.MRI appearances of multiple rice body formation in chronic subacromial and subdeltoid bursitis, in association with synovial chondromatosis[J]. Clin Radiol, 2004, 59(8): 753-757.
[7] Iyengar K, Manickavasagar T, Nadkarni J, et al.Bilateral recurrent wrist flexor tenosynovitis and rice body formation in a patient with sero-negative rheumatoid arthritis: a case report and review of literature[J]. Int J Surg Case Rep, 2011, 2(7): 208-211.
[8] Aletaha D, Neogi T, Silman AJ, et al.2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative[J]. Arthritis Rheum, 2010, 62(9): 2569-2581.
[9] Popert AJ, Scott DL, Wainwright AC, et al.Frequency of occurrence, mode of development, and significance or rice bodies in rheumatoid joints[J]. Ann Rheum Dis, 1982, 41(2): 109.
[10] Qi W, Ren Y, Wang H, et al.Candida parapsilosis-caused arthritis with rice body formation: a case presentation and literature review[J]. Infect Drug Resist, 2023, 16(1): 4123-4135.
[11] Park JP, Marwan Y, Alfayez SM, et al.Arthroscopic management of synovial chondromatosis of the shoulder: a systematic review of literature[J]. Shoulder Elbow, 2022, 14(1 Suppl): 5-15.
[12] Rousslang LK, Rooks E, Hixson C, et al.Tumefactive synovial thickening mimicking synovial chondromatosis in the setting of oligoarticular juvenile idiopathic arthritis in a toddler[J]. Radiol Case Rep, 2020, 15(3): 218-221.
[13] Agha RA, Fowler AJ, Saeta A, et al.The SCARE Statement: consensus-based surgical case report guidelines[J]. Int J Surg (Lond Engl), 2016, 34: 180-186.
[14] 徐晖, 姜熙平, 胡庆翔, 等. 巨大肩袖损伤的临床治疗新进展[J]. 外科研究与新技术(中英文),2024,13(1):1-6,99.
[15] Berg E, Wainwright R,Barton B,et al.On the nature of rheumatoid rice bodies: an immunologic,histochemical, and electron microscope study[J].Arthritis Rheum, 1977, 20(7): 1343-1349.
[16] Cheung HS, Ryan LM, Kozin F, et al.Synovial origins of rice bodies in joint fluid[J]. Arthritis Rheum, 1980, 23(1): 72-76.
[17] Wynne-Roberts CR, Cassidy JT.Juvenile rheumatoid arthritis with rice bodies: light and electron microscopic studies[J]. Ann Rheum Dis, 1979, 38(1): 8-13.
[18] McCarthy DJ, Cheung H S. Origin and significance of rice bodies in synovial fluid[J]. Lancet, 1982, 2(8300): 715-716.
[19] Raju KP, Kumar JM, Shetty R.Tuberculous tenosynovitis of ankle with rice bodies[J]. Foot Ankle Online J, 2013, 6(10): 1.
[20] 葛冠男, 钱军. 关节镜手术治疗5例肩关节米粒体性滑囊炎[J]. 中华骨与关节外科杂志, 2017, 10(3): 212-215.
[21] Edison MN, Caram A, Flores M, et al.Rice body formation within a peri-articular shoulder mass[J]. Cureus, 2016,8(8):e718.

复发性肩峰下米粒体滑囊炎的关节镜治疗及病理特征——附1例报道及文献回顾

Arthroscopic treatment and pathological features of recurrent subacromial rice body bursitis： Report of 1 case and literature review

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