Joosen H, Mellaerts B, Dereymaeker G, Westhovens R
Department of Rheumatology, University Hospitals KU Leuven, Belgium.
Clin Rheumatol. 2000;19(5):392-5. doi: 10.1007/s100670070035.
We report the case of a 34-year-old man with a rheumatoid pulmonary nodule preceding the development of articular symptoms of rheumatoid arthritis. Pulmonary nodules are a well known feature of rheumatoid arthritis and are mostly seen in severe established rheumatoid factor-positive cases. To differentiate between benign and malign pulmonary nodules we discuss the use of positron emission tomography (PET). Despite intensive therapy with steroids and methotrexate in our patient, within months he developed a severe tibialis posterior tendinitis, with partial rupture and evolution to a planovalgus deformity requiring surgery. Both these symptoms are rare but demonstrate the need for close follow-up in early rheumatoid arthritis.
我们报告了一例34岁男性病例，其在类风湿性关节炎关节症状出现之前就有类风湿性肺结节。肺结节是类风湿性关节炎的一个众所周知的特征，多见于严重的、确诊的类风湿因子阳性病例。为了鉴别良性和恶性肺结节，我们讨论了正电子发射断层扫描（PET）的应用。尽管对我们的患者使用了类固醇和甲氨蝶呤进行强化治疗，但在数月内他仍出现了严重的胫后肌腱炎，伴有部分断裂，并发展为扁平外翻畸形，需要手术治疗。这两种症状都很罕见，但表明早期类风湿性关节炎需要密切随访。
