Milchert Marcin, Trzcińska-Butkiewicz Beata, Ostanek Lidia, Bohatyrewicz Andrzej, Brzosko Marek
Kliniki Reumatologii, Pomorskiej Akademii Medycznej w Szczecinie.
Wiad Lek. 2006;59(11-12):873-8.
Primary hypertrophic osteoarthropathy (HOA) is a rare cause ofjoint pain. The diagnosis is often delayed, due to mild complaints. However, finger clubbing combined with joint pain should suggest considering HOA in the diagnosis. The progression of toes and fingertips widening is slow and can be overlooked by a patient. It is common that patient seeks physician's aid only when the joint pain occurs. The presented case is an example of delayed diagnosis. Due to the fact that secondary HOA coexists with some diseases associated with serious prognosis it is recommended to exclude other possible causes before diagnosing primary HOA. Some clues, like the age of disease onset or positive family history allow the diagnosis of primary HOA with high probability. This case report contains clinical symptoms and new diagnostic criteria, differential diagnosis, and possible complications.
原发性肥大性骨关节病(HOA)是关节疼痛的罕见病因。由于症状轻微,诊断往往会延迟。然而,杵状指合并关节疼痛应提示在诊断中考虑HOA。脚趾和指尖增宽的进展缓慢,可能会被患者忽视。患者通常仅在关节疼痛时才寻求医生帮助。本病例就是诊断延迟的一个例子。由于继发性HOA与一些预后严重的疾病并存,建议在诊断原发性HOA之前排除其他可能的病因。一些线索,如发病年龄或阳性家族史,有助于高度疑似原发性HOA的诊断。本病例报告包含临床症状、新的诊断标准、鉴别诊断及可能的并发症。