Pauser J, Carl H-D, Swoboda B, Jendrissek K A
Abteilung für Orthopädische Rheumatologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Im Waldkrankenhaus St. Marien, Rathsberger Str. 57, 91054, Erlangen, Deutschland.
Z Rheumatol. 2011 Dec;70(10):866-73. doi: 10.1007/s00393-011-0889-0.
Insufficiency fractures are generally a rare event, especially of the hindfoot. These are often overlooked in the initial stage, however, they must be regarded as a differential diagnosis in the range of possible causes in patients with rheumatoid arthritis and unclear complaints.
Outpatients in an arthritis care unit from 2009-2011 were analyzed for fractures of the hindfoot and distal tibia.
A total of six patients with seven fractures without adequate trauma were found in the cohort. All patients had received disease modifying therapy and corticosteroids. All fractures could be successfully treated without surgery.
Insufficiency fractures in patients with rheumatoid arthritis are a typical finding after several years of the disease. They are directly related to the disease and medication and can usually be successfully treated conservatively.
应力性骨折通常较为罕见,尤其是后足应力性骨折。这类骨折在初期常被忽视,然而,在类风湿关节炎患者出现不明原因疼痛时,应力性骨折必须被视为可能病因之一进行鉴别诊断。
对2009年至2011年关节炎护理单元的门诊患者进行后足和胫骨干骺端骨折分析。
该队列中总共发现6例患者有7处骨折,均无明显外伤史。所有患者均接受过改善病情的治疗及皮质类固醇治疗。所有骨折均无需手术即可成功治愈。
类风湿关节炎患者的应力性骨折是疾病数年发展后的典型表现。它们与疾病及药物直接相关,通常保守治疗即可成功治愈。