Lehtinen J T, Kaarela K, Belt E A, Kauppi M J, Lehto M U
Department of Surgery, Tampere University Hospital, Finland.
Scand J Rheumatol. 1999;28(4):252-3. doi: 10.1080/03009749950155634.
An inception cohort of 74 patients with seropositive and erosive RA were followed up for 15 years. All 148 shoulders were radiographed with a standard method at the 15-year follow-up. The coracoclavicular region was evaluated from each radiograph. In addition, the distance between the processus coracoideus and the superior margin of the clavicle was measured. Only one clavicle had elongated, shallow erosion on the undersurface at the insertion area of the coracoclavicular ligaments. In this case the distance between the coracoid process and clavicle was 25 mm, whereas the mean distance of all shoulders (n = 148) was 17.4 mm (range 9 25 mm). We conclude that resorption on the undersurface of the distal clavicle is an atypical manifestation in rheumatoid arthritis. The origin of this atypical lesion is a not diminished distance between the processus coracoideus and the clavicle. Inflammation of the coracoclavicular ligaments is most likely the reason for this lesion.
对74例血清学阳性且有侵蚀性类风湿关节炎的患者起始队列进行了15年的随访。在15年随访时，对所有148个肩部均采用标准方法进行了X线摄影。从每张X线片评估喙锁区域。此外，测量了喙突与锁骨上缘之间的距离。仅1例锁骨在喙锁韧带附着区域的下表面有细长、浅表的侵蚀。在该病例中，喙突与锁骨之间的距离为25mm，而所有肩部（n = 148）的平均距离为17.4mm（范围9～25mm）。我们得出结论，锁骨远端下表面的吸收是类风湿关节炎中的一种非典型表现。这种非典型病变的起源是喙突与锁骨之间的距离未减小。喙锁韧带的炎症很可能是该病变的原因。
