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腕和手部腱鞘囊肿

Author
Filip De Keyser, MD, PhD
Section Editor
Zacharia Isaac, MD
Deputy Editor
Monica Ramirez Curtis, MD, MPH

引言

腱鞘囊肿是手和腕部最常见的软组织肿胀之一。虽然腱鞘囊肿为良性病变，但其可能导致疼痛、无力和功能丧失，有时需要治疗。

本文将讨论腕及手部腱鞘囊肿的表现、诊断、鉴别诊断和治疗。 手或腕部疼痛成人的评估将单独讨论。 (参见“成人急性腕部疼痛的评估”和“成人亚急性或慢性腕痛的评估”和“手部疼痛患者的评估”)

腱鞘囊肿的描述

腱鞘囊肿是发生于关节或腱鞘，内含液体的囊性肿物。被认为由致密结缔组织疝出腱鞘、韧带、关节囊、滑囊和半月板引起。腱鞘囊肿内含有黏液性胶状液体。

最常见的位置为腕部背侧(占70%)(图片 1)[1]。大多数腕背侧腱鞘囊肿可通过沿着“柄”追溯，发现起源于桡月韧带[2]。这些囊肿可能呈单房性或多房性。手部腱鞘囊肿的第二常见部位为腕部掌侧(占20%)，位于舟骨小多角骨关节。腱鞘囊肿也可源自指屈肌腱鞘，文献中通常描述为源自手指第一环状(A1)滑车(图 1)。在手指基底部的屈褶线处可能触及一个小肿块。

手指/足趾黏液(或黏液性)囊肿是一种在远端指/趾间(distal interphalangeal, DIP)关节背侧形成的腱鞘囊肿[3]。最常发生在40-70岁，通常伴有潜在骨关节炎诊断。

                   

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Literature review current through: 2017-06 . | This topic last updated: 2017-06-08.
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