Diz Ekleminin Neoplastik Hastalıkları
Özet
Diz eklemi ve çevresi, alt ekstremitede neoplastik hastalıkların en sık yerleştiği bölgelerden biridir. Bu lezyonlar, kontrolsüz hücre çoğalmasıyla ilerleyen anormal doku kitleleri olup benign (iyi huylu) ve malign (kötü huylu) tümörler veya tümör benzeri yapılar olarak sınıflandırılır. Sık görülen benign tümörler arasında osteoid osteoma, osteokondrom ve enkondrom yer alırken; osteosarkom, Ewing sarkomu ve kondrosarkom en yaygın primer malign tümörlerdendir. Tanı sürecinde hastanın yaşı, semptomların karakteri (özellikle malign tümörlerde gece ve istirahat ağrısı) ile klinik muayene ilk adımı oluşturur. Radyolojik görüntüleme yöntemleri ise ayırıcı tanıda, tümörün agresifliğini belirlemede ve evrelemede kritik role sahiptir. Direkt radyografi kemik harabiyetini ve periost reaksiyonlarını gösterirken, MR görüntüleme tümörün boyutunu, kemik içi-çevresi yayılımını ve damar-sinir tutulumunu başarılı şekilde tespit eder. Malign kemik tümörleri sıklıkla akciğere metastaz yaptığından evrelemede akciğerlerin taranması hayati önem taşır.
The knee joint and its surrounding area represent one of the most common sites for neoplastic diseases in the lower extremity. These lesions are characterized as abnormal tissue masses with uncontrolled cell proliferation, categorized into benign and malignant tumors, or tumor-like lesions. Common benign neoplams include osteoid osteoma, osteochondroma, and enchondroma, whereas osteosarcoma, Ewing sarcoma, and chondrosarcoma constitute the most frequent primary malignant tumors. The diagnostic workflow initiates with evaluating patient age, symptom presentation—notably progressive night and rest pain in malignant cases—and clinical examination. Radiological imaging plays a pivotal role in differential diagnosis, assessing tumor aggressiveness, and staging. While conventional radiography demonstrates cortical destruction and periosteal reactions, MRI successfully determines tumor size, intramedullary extension, and neurovascular involvement. Given that malignant bone tumors predominantly metastasize to the lungs, evaluating the chest during staging is crucial for appropriate treatment planning.
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