Liu Chih-Hsin, Liu Wen-Chung, Chen Lee-Wei, Chen Jin-Shyr
Division of Reconstructive & Plastic Surgery, Department of Surgery, National Yang-Ming University, Kaohsiung, Taiwan, Republic of China.
Clin Rheumatol. 2008 Jun;27 Suppl 1:S7-9. doi: 10.1007/s10067-007-0799-3. Epub 2008 Jan 26.
Extraspinal musculoskeletal tuberculosis (TB) was an uncommon manifestation with a frequency about 1 to 2% in all TB patients. According to the report, tuberculous arthritis and osteomyelitis remained the two leading etiologies, while others constituted less than 2% of all extraspinal musculoskeletal tuberculous infections; less than 0.04% of those who suffered from TB were represented as extraspinal musculoskeletal tuberculous infections, neither tuberculous arthritis- nor osteomyelitis-associated. We presented one extremely rare case of primary tuberculous myofasciitis manifesting painful swelling on the left thigh without previous history of tuberculous infection in a patient with dermatomyositis. We also lodged several predisposing symptoms, such as gradually enlarging swelling of extremity within months and proximal muscle painful weakness with prompt response to steroid, which may help early diagnosing of analogous extraspinal musculoskeletal tuberculosis in dermatomyositis patients; and seasonable administrating of anti-TB agents could prevent deterioration in advance.
脊柱外肌肉骨骼结核在所有结核病患者中是一种不常见的表现形式,出现频率约为1%至2%。根据报告,结核性关节炎和骨髓炎仍然是两个主要病因,而其他病因在所有脊柱外肌肉骨骼结核感染中占比不到2%;患有结核病的患者中,不到0.04%表现为脊柱外肌肉骨骼结核感染,既非结核性关节炎也非骨髓炎相关。我们报告了一例极其罕见的原发性结核性肌筋膜炎病例,该患者患有皮肌炎,左大腿出现疼痛性肿胀,且既往无结核感染史。我们还提出了一些易感症状,如数月内肢体肿胀逐渐增大以及近端肌肉疼痛性无力且对类固醇治疗反应迅速,这可能有助于皮肌炎患者早期诊断类似的脊柱外肌肉骨骼结核;及时使用抗结核药物可提前预防病情恶化。