腘窝囊肿综述中英文对照

PoplitealCysts:ACurrentReviewAlyssaM.Herman,BS;JohnM.Marzo,MDZhuxiTheOrthopaedicsofGeneralHospitalofNMUTheauthorsarefromtheDepartmentofExerciseandNutritionSciences(AMH)andtheDepartmentofOrthopaedics(JMM),UniversityatBuffalo,Buffalo,NewYork.OrthopedicsAbstractOfthepossiblecysticlesionsaroundthekneejoint,poplitealcystsarethemostprevalent.Poplitealcystsmostcommonlyformbydistentionofthegastrocnemio-semimembranosusbursa,whichislocatedinthemedialaspectofthepoplitealfossa.ThesecystsarealsoreferredtoasBaker’scysts,anamegiventotheconditionafterBaker’sclassiccasedescriptionofpoplitealswelling腘窝囊肿是膝关节周围最常见的囊性病变。腘窝囊肿通常由腘窝内侧的腓肠肌-半膜肌滑囊膨胀形成，最早由Baker报道，又称Baker’s囊肿。AbstractThegastrocnemio-semimembranosusbursaissituatedbetweenthetendonsofthegastrocnemiusandsemimembranosusmusclesandisanormalanatomicfinding.腓肠肌-半膜肌滑囊是位于腓肠肌、半膜肌肌腱之间的正常解剖组织。AbstractThisbursahasbeenfoundtocommunicatewiththekneejointcapsuleviaatransverseopeningintheposteriorcapsuleatthelevelofthemedialfemoralcondyle,wherethegastrocnemiustendonmergeswiththejointcapsule.该滑囊通过一横孔与膝关节囊腔相通，横孔位于股骨内侧髁水平处的关节囊后部。且腓肠肌肌腱与膝关节囊在股骨内侧髁处相连。AbstractMostoften,thisopeningtakestheshapeofahorizontalslitmeasuring4to24mm.Thecommunicationbetweenthebursaandthejointcapsuleisalmostnonexistentinchildren,andthepresenceofthisopeningincreasesinfrequencywithage.横孔通常是4到24毫米大小的水平裂缝。滑膜囊腔通常在儿童阶段并不与关节腔相通，随着年龄的增加，出现缺口的几率也增加。AbstractTheintegrityofthejointcapsuledecreaseswithage,anditistheorizedthatthisopeningresultsfromatearinthedegeneratedjointcapsule.Rauschningobservedthat,whennoopeningwasfound,capsularthinningwasseeninthesameareaandnotedthatthecystissimplyaherniationofsynovium,asoriginallypostulatedbyBaker.膝关节囊完整性随着年龄增加而减低，有理论认为缺口是由于退化的膝关节囊撕裂后所致。Rauschning观察到，对无关节缺口的人群，在囊肿的同一区域仍可观察到关节囊，提示腘窝囊肿可能是贝克最初假设的滑膜疝出所致。AbstractAtrueganglioncystcanform,usuallybyfluidleakagethroughahorizontalorobliquemedialmeniscustear,formingawallofdensefibrousconnectivetissue(notsynovium)asadistinguishingfeature(Figure1).真正腱鞘囊肿通常是液体从斜行或水平内侧半月板裂隙渗出形成，其明显的特征是形成厚厚的纤维连接组织壁（不是滑膜）（图.1）。AbstractAbstractThecommunicationbetweenthegastrocnemio-semimembranosusbursaandthejointcapsule,whichallowsforthemovementofsynovialfluidbetweenthe2spaces,hasbeenshownbyarthrography.Avalvelikemechanismthatallowsonlyunidirectionalflowfromthejointintothebursahasbeenfoundinsomeoftheseopenings.关节造影术显示，关节液在腓肠肌-半膜肌滑囊与膝关节囊互通的两个腔隙之间运动。在有些互通缺口中发现类瓣膜机制，只允许关节液单方向流向滑囊。AbstractIntra-articularandintracysticpressuremeasurementshavebeenmadeinthekneesofpatientswithrheumatoidarthritiswhohavepoplitealcysts，andineverycaseintracysticpressurewashigherthanintra-articularpressure.Thesefindingsoffluidaccumulatinginthepoplitealcystandnotbeingabletoleave,despitehighpressure,indicatethepresenceofa1-wayvalve-typemechanism.测量类风湿患者腘窝囊肿内压和关节内压发现，所有患者囊肿内压高于关节内压。这些发现提示，液体积聚在囊肿内，尽管内压高，但并不流走，表明存在单向瓣膜机制。ClinicalPresentationInchildren,apoplitealcystismostoftenanincidentalfindingonphysicalexamination.Occasionallyachildorparentseesorfeelsacystandbecomesconcernedaboutthepresenceofamass.儿童中，腘窝囊肿常在体检中偶然发现。有时父母因肿块（囊肿）发现囊肿。ClinicalPresentationTypicaladultclinicalpresentationisvagueposteriorkneepain,possiblelocalizedswellingormass,andafeelingoftightnessinthepoplitealregion.Physicalexaminationmayshowatenderpalpablemassinthemedialpoplitealfossa,althoughthisfindingissubjectiveandissomewhatdependentonthephysician’sopinionandexperience。成人临床常表现为膝后部隐约痛，局部肿胀及肿块，腘窝区域紧张感。物理查体可以发现在内侧腘窝可触及柔软肿块。这还有赖于医生主观的经验。ClinicalPresentationMostcystsarefoundonthemedialsideoftheposteriorkneeandarereportedmorerarelyonthelateralside.Thecystisusuallyrounded,smooth,andfluctuant,andmayfeeltenseinextension,butthisisadifficultfindingtoquantify.ThishardnessofthecystinfullextensionfollowedbysofteningwithkneeflexionisknownasFoucher’ssign囊肿在膝关节后内侧，很少在外侧，呈圆形，光滑，波动感，扩张时可能紧张，但是这很难量化。膝关节伸直时，囊肿变硬，屈曲时软化，称为Foucher征。ClinicalPresentationCalfpainandswellingarealsopresentinDVTorsuperficialthrombophlebitis,andtheclinicalimperativeistoruleoutDVTwithappropriatediagnosticimagingstudies.PseudothrombophlebitishasthesameclinicalpresentationasDVTorsuperficialthrombophlebitis,butiscausedbyanothercondition，suchasarupturedpoplitealcyst.DVT和表浅性血栓静脉炎也会出现上述症状，因此影像学检查排除DVT很有必要。假性血栓性静脉炎临床表现同DVT和表浅性血栓静脉炎相同，比如破裂的腘窝囊肿就可以引起。ClinicalPresentationDiscolorationorecchymosisinthecalf,atthemedialmalleolus,oronthedorsumofthefootisadistinguishingfeatureofarupturedcystbecausebloodysynovialcystfluiddissectsinferiorly.Treatmentofrupturedcyststypicallyinvolvestreatingresultantcomplications,butrupturedcystswithoutcomplicationshavebeenreportedtoresolvespontaneouslywithsupportiveconservativecare,suchascompressionandelevationofthelimb.在小腿，内踝或是足背出现变色或是瘀斑是囊肿破裂的特异性特征。囊肿破裂后治疗通常是治疗相应的并发症，然而无并发症的破裂囊肿在保守支持治疗下可自行缓解，如抬高或加压患肢。DiagnosticImagingMultipleimagingtechniquesmaybeusedinthediagnosisandassessmentofapoplitealcyst.Plainradiographsaresimpleandreadilyavailable,buttheyprovidelimitedinformationaboutthepoplitealcyst.However,theymayhelpinidentifyingassociatedarticulardisorders,suchasloosebodiesinthecystorthegeneralfindingsofosteoarthritisandinflammatoryarthritis.诊断和评