[滑膜鞘结核的误诊分析]
[Analysis of misdiagnosis of tuberculosis in the synovial sheath].
作者信息
Xu Jie, Huang Jing, Liu Yong
机构信息
Department of Orthopaedic, Second Affiliated Hospital of Sun Yat-sen University, Guangzhou 510120, China.
出版信息
Zhonghua Jie He He Hu Xi Za Zhi. 2007 Feb;30(2):121-3.
OBJECTIVE
To investigate the factors for misdiagnosis of tuberculosis in synovial sheath, and therefore to improve the early diagnosis of the disease.
METHODS
From January 1991 to December 2003, 15 cases of tuberculosis in the synovial sheath were treated using surgery and anti-tuberculous agents. The clinical features and the related factors for misdiagnosis were analyzed.
RESULTS
The duration from onset of symptom and sign to a final diagnosis was (16 +/- 10) months (range from 2 to 36 months). Twelve cases were misdiagnosed before surgery. All cases were followed up for 2.5 to 7 years without recurrence, except one case of systemic lupus erythematosus complicated with tuberculosis of the wrist and the ankle 1 month after operation.
CONCLUSION
Lack of specific symptoms and signs, nonspecific radiological manifestations and over-dependence on laboratory examinations were the major factors responsible for early misdiagnosis.
目的
探讨滑膜鞘结核误诊的相关因素，以提高该病的早期诊断率。
方法
1991年1月至2003年12月，采用手术及抗结核药物治疗15例滑膜鞘结核患者。分析其临床特征及误诊的相关因素。
结果
从出现症状和体征到最终确诊的时间为（16±10）个月（范围2至36个月）。12例患者术前被误诊。除1例术后1个月发生系统性红斑狼疮合并腕关节及踝关节结核外，所有患者均随访2.5至7年，无复发。
结论
缺乏特异性症状和体征、非特异性影像学表现以及过度依赖实验室检查是早期误诊的主要原因。
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