Linlin, a 5-year-old girl, suddenly refused to walk last month. She always had to hold her and cried out that her legs hurt when playing. The child's parents found space occupying lesions behind the left knee and fluid accumulation in the joint cavity through MRI examination in their home hospital. The doctor suggested that they go to the provincial capital hospital for treatment immediately. After many inquiries, parents found Professor Gui Jianchao, doctoral supervisor and chief physician of Nanjing First Hospital. Experts conducted detailed consultation and comprehensive physical examination. In combination with MRI, Director Gui considered that the child was pigmented villonodular synovitis, a rare benign tumor of the synovium, which must be operated within a time limit. Otherwise, the diseased synovium would erode the surrounding normal tissues, destroy the normal results of the joint cavity, and lead to joint dysfunction in the child, with unimaginable consequences.
After careful preoperative examination and preparation, on October 31, the child underwent arthroscopic minimally invasive surgery. The focus of the child is closely attached to the posterior cruciate ligament. The diseased synovium must be completely and thoroughly removed, otherwise it is very easy to recur, but the important posterior cruciate ligament cannot be injured during the operation. In addition, the focus of the patient is located in the posterior compartment of the knee joint, and a trans mediastinal approach behind the knee joint needs to be established to perform surgery. The operation only took half an hour, and the synovial tumor was completely removed.
According to Gui Jianchao, Linlin's pigmented villonodular synovitis is actually a synovial disease between inflammation and benign tumors. If it is found that children aged 3-10 often have swollen joints and are unwilling to walk, parents will pay attention to it. "This disease is rare, but if it is diagnosed, it usually requires surgery to completely remove the hyperplastic synovium. If it is delayed for too long, it may lead to the formation of long and short feet in serious cases." In addition, Director Gui reminded that this disease is easily mistaken by parents for growth pain, which most commonly occurs in the front of the knee, calf and thigh, and occasionally in the groin area, The pain is generally outside the joint, typically bilateral pain, but also pain on one side. There is no need for special treatment when growth pain occurs. The most effective way is to give local massage and hot compress to children to help reduce the pain. Correspondent Zhang Chen and reporter Qi Zaibing
