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MR Vol.12 No.2 indexに戻る
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MODERN RHEUMATOLOGY
Vol.12 No.2 |
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Development of large pseudocysts adjacent
to the knee joint in rheumatoid arthritis. Assessment of radiological
and histopathological approaches |
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| M. Yoshida1, S. Ichinohe1, M. Uzuki2, W.
Yoshida2, T. Sawai A2, T. Shimamura A1 |
A1 Department of Orthopaedics and Rheumatology,
Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka
020-8505, Japan Tel. +81-19-651-5111 (ext. 6405); Fax +81-19-626-3699
e-mail: masayosi@iwate-med.ac.jp
A2 Department of First Pathology, Iwate Medical University School of Medicine,
Morioka, Japan |
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| Abstract |
| Abstract This study examined the pathogenesis
of large pseudocysts adjacent to knee joints in rheumatoid arthritis
(RA). The radiological and histopathological features of 17 large
subarticular pseudocysts in 12 knee joints of 10 patients were analyzed.
Nine of the 10 patients were classified as class 2 according to Steinbrocker's
functional class. Eight large pseudocysts were located at the lateral
femoral condyle, seven were at the proximal part of the tibia, one
was at the medial femoral condyle, and one was at the patella. The
large pseudocysts were divided into two groups according to whether
they did or did not connect with the joint cavity. Serial radiographs
revealed that all large pseudocysts in communication with the joint
cavity had enlarged gradually over the past several months. They
extended from the subarticular area toward the bone marrow. Histopathological
findings confirmed that holes allowing communication were located
at a transitional zone between the ligament and the hyaline cartilage,
and that rheumatoid granulation tissue invaded the large pseudocyst
through these holes. The results of this study indicate that large
pseudocysts are formed by the extension of articular inflammation.
Moreover, repeated extrinsic mechanical stress due to walking and
the aggressive inflammatory nature of rheumatoid arthritis play important
roles in the formation of large pseudocysts. |
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| Key words |
| Key words Bare area ・ Bone cyst ・ Knee joint
・ Pseudocyst ・ Rheumatoid arthritis (RA) |
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