Sugimoto H, Hyodoh K, Kikuno M, Furuse M
Department of Radiology, Jichi Medical School, Tochigi-ken, Japan.
J Rheumatol. 1999 Mar;26(3):574-9.
To describe the radiologic manifestations of periarticular calcification in patients with systemic lupus erythematosus (SLE) and to investigate clinical variables associated with its occurrence.
Hand radiographs and clinical records of 52 patients who had 4 or more features of the 1982 revised criteria for classifying SLE and who had no other collagen vascular diseases were analyzed retrospectively.
Periarticular calcifications were found in 7 patients (13.5%) near the distal and proximal interphalangeal (DIP and PIP) joints and metacarpophalangeal (MCP) joints. No significant association with calcification was noted for the following variables: age at disease onset, duration of the disease, sex, the maximum value of the serum calcium, organic phosphate, and uric acid, Raynaud's phenomenon, lupus nephritis, femoral avascular necrosis, central nervous system lupus, proteinuria, or the use of drugs such as corticosteroids, synthetic vitamin D, and nonsteroidal antiinflammatory drugs. However, a significant association was noted with the use of furosemide (p < 0.01 by chi-square). In 5 patients periarticular calcification was observed during or just after hyperuricemia had developed while taking diuretics.
Periarticular calcification in patients with SLE was seen in the DIP, PIP, and MCP joints, and appeared to be associated with the use of diuretics. If patients with SLE are prescribed a diuretic regimen, crystal associated arthritis should be considered as a possibility when diagnosing oligoarthritis.
描述系统性红斑狼疮（SLE）患者关节周围钙化的放射学表现，并研究与其发生相关的临床变量。
回顾性分析52例具有1982年修订的SLE分类标准中4项或更多特征且无其他胶原血管疾病患者的手部X线片和临床记录。
7例（13.5%）患者在远端和近端指间关节（DIP和PIP）以及掌指关节（MCP）附近发现关节周围钙化。对于以下变量，未发现与钙化有显著相关性：发病年龄、病程、性别、血清钙、有机磷和尿酸的最大值、雷诺现象、狼疮性肾炎、股骨头缺血性坏死、中枢神经系统狼疮、蛋白尿，或使用皮质类固醇、合成维生素D和非甾体抗炎药等药物。然而，发现与使用速尿有显著相关性（卡方检验p < 0.01）。5例患者在服用利尿剂期间或高尿酸血症刚出现后观察到关节周围钙化。
SLE患者的关节周围钙化见于DIP、PIP和MCP关节，似乎与使用利尿剂有关。如果给SLE患者开了利尿剂治疗方案，在诊断少关节炎时应考虑晶体相关性关节炎的可能性。
