Akizuki M, Homma M
Department of Medicine, Keio University School of Medicine, Tokyo.
Ryumachi. 1991 Jun;31(3):311-6; discussion 316-7.
A 41 year-old female presented with swelling of lower extremities and polyarthralgia involving both knee joints. Physical examination revealed presence of finger clubbing, tenderness and pain-on-motion in knee and foot joints. A chest X-ray film showed a solitary tumor in the right mid-lung field. There were subperiosteal new bone formation and radioisotope accumulation in the legs bilaterally. The clubbing, periostitis and arthritis confirmed a diagnosis of hypertrophic osteoarthropathy. Adenocarcinoma was the biopsy diagnosis of the lung tumor. The characteristic features of hypertrophic osteoarthropathy resolved after surgical resection of the pulmonary lesion followed by chemotherapy. This case demonstrates a typical example of identification of a treatable malignant condition by rheumatic symptoms.
一名41岁女性出现下肢肿胀及累及双膝关节的多关节痛。体格检查发现有杵状指,膝关节和足部关节有压痛及活动痛。胸部X线片显示右肺中野有一个孤立性肿瘤。双侧腿部有骨膜下新骨形成及放射性同位素聚集。杵状指、骨膜炎和关节炎确诊为肥厚性骨关节病。肺肿瘤活检诊断为腺癌。肺部病变手术切除并化疗后,肥厚性骨关节病的特征性表现消失。该病例是通过风湿症状识别出可治疗的恶性疾病的典型例子。