Seggewiss Ruth, Hess Thomas, Fiehn Christoph
Department of Internal Medicine V, University of Heidelberg, Hospitalstr. 3, 69115, Heidelberg, Germany.
Joint Bone Spine. 2003 Jun;70(3):230-3. doi: 10.1016/s1297-319x(03)00048-4.
We report a case of a family with a variant form of primary hypertrophic osteoarthropathy (HOA) restricted to the lower extremities without digital clubbing or cutaneous changes. Three family members suffered from pain, swelling and hyperhidrosis of both feet. X-rays showed destruction and osteoproliferative changes of the metatarsal bones with periostal hyperostosis close to the talus. There was an increased 99m-Tc-MDP uptake in the early phase of bone scintigraphy. Fibrosis of the marrow with stimulated osteoclastic resorption and the presence of detritus synovialitis were visible in a bone and joint biopsy. All known infectious, neurologic, metabolic and malignant diseases, which affect the bone and joints, were excluded.
我们报告了一例原发性肥厚性骨关节病（HOA）的变异型病例，该病例局限于下肢，无杵状指或皮肤改变。三名家庭成员双脚均出现疼痛、肿胀和多汗。X线显示跖骨破坏及骨质增生改变，距骨附近有骨膜增生。骨闪烁显像早期99m锝-亚甲基二膦酸盐（99m-Tc-MDP）摄取增加。骨与关节活检可见骨髓纤维化伴刺激的破骨细胞吸收及碎屑性滑膜炎。所有已知影响骨骼和关节的感染性、神经性、代谢性和恶性疾病均被排除。
