Li Ko-Jen, Yu Chia-Li, Hsu Chao-Yu, Hsieh Song-Chou, Hsu Ping-Ning
Division of Immunology, Rheumatology and Allergy, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
J Formos Med Assoc. 2006 Aug;105(8):685-8. doi: 10.1016/S0929-6646(09)60170-4.
Discovertebral erosion with pseudoarthrosis is a well-known complication in ankylosing spondylitis but it is seldom mentioned in psoriatic arthritis. We report a 53-year-old woman with an 8-year history of psoriatic arthritis who developed severe low back pain followed by sudden onset of numbness in the lower limbs, weakness and dysesthesia. Abnormal contour of L1 and L2 vertebrae and intervertebral disc space was noted during radiologic examination. Pseudoarthrosis was suspected based on extensive osseous resorption and reactive sclerosis about the discovertebral junction on magnetic resonance imaging study. She underwent emergency operation due to spinal instability with neurologic deficit. Pseudoarthrosis was confirmed intraoperatively. No evidence of infection or neoplasms was found. This case shows that pseudoarthrosis can be complicated in patients with psoriatic arthritis, and this possibility should be considered in patients with previously quiescent disease.
伴有假关节形成的椎体侵蚀是强直性脊柱炎中一种众所周知的并发症，但在银屑病关节炎中很少被提及。我们报告一名53岁患有8年银屑病关节炎病史的女性，她出现严重的下背部疼痛，随后突然出现下肢麻木、无力和感觉异常。影像学检查发现L1和L2椎体及椎间盘间隙轮廓异常。磁共振成像研究显示，在椎体间关节处有广泛的骨质吸收和反应性硬化，怀疑有假关节形成。由于脊柱不稳定并伴有神经功能缺损，她接受了急诊手术。术中证实为假关节形成。未发现感染或肿瘤的证据。该病例表明，银屑病关节炎患者可能并发假关节形成，对于既往病情静止的患者应考虑到这种可能性。
