肩関節に発生した滑膜骨軟骨腫症に対し鏡視下手術を施行した1例

Arthroscopic Treatment of Synovial Osteochondromatosis of the Shoulder. Case Report

　患者は17歳の男性で，誘因なく左肩関節痛が出現し，当院を紹介されて受診した．X線，空気造影後CTで肩甲上腕関節および肩甲下滑液包内に複数の遊離体を認め，滑膜骨軟骨腫症と診断し鏡視下手術を施行した．肩甲上腕関節には滑膜炎を軽度認め，大きな3個の遊離体を認めた．また，前方関節唇の9時から11時の位置にsublabral foramenを認め肩甲下滑液包と交通していた．同foramenから肩甲下滑液包内に大小様々な遊離体を多数認めたために，滑膜切除および遊離体摘出術を施行した．術後1年の現在，症状はなく再発も認めていない．

　The patient was a 17-year-old man who complained of left shoulder pain.　Plain radiographs and pneumoarthrographic CT revealed numerous calcified granules in the left glenohumeral joint and subscapular bursa, and a diagnosis of synovial osteochondromatosis was made.　Shoulder arthroscopy revealed three large loose bodies, mild synovitis, and a sublabral foramen from 9 o'clock to 11 o'clock on the glenoid.　The foramen communicated with the subscapular bursa, and many loose bodies were observed in the bursa.　The loose bodies were removed and partial synovectomy performed via standard posterior and anterior arthroscopic portals.　At the most recent follow-up examination 12 months postoperatively, there was both subjective and objective improvement.　Radiography showed no recurrence of the loose bodies.