Ahmad Zafar, Skinner John, Field Richard
Queen Mary's Hospital, Sidcup, London, UK.
BMJ Case Rep. 2010 Nov 12;2010:bcr0220102759. doi: 10.1136/bcr.02.2010.2759.
A 50-year-old lady with a background of Perthes disease and multiple bilateral hip revisions presented with symptoms of right hip pain. She was unable to raise and weight bear on the right leg. Hip examination revealed limited flexion and extension to 15-20 ° due to pain. Her blood tests and x-rays showed no obvious acute problems. She was treated with mobilisation and analgesia, and had a bone scan that revealed no acute issues. Further examination revealed she had generalised weakness in her upper arm. A creatine kinase marker showed a level of over 2000. Therefore, an MRI and a muscle biopsy were done. A diagnosis of sarcoid myositis was made and the patient was put on steroids. She was able to make a full recovery. This case highlights the consideration of rare diseases in more highly complex cases.
一位50岁女性,有佩特兹病病史且双侧髋关节多次翻修,现出现右髋疼痛症状。她无法抬起右腿并负重。髋关节检查发现因疼痛导致屈伸受限至15 - 20°。她的血液检查和X光片未显示明显急性问题。她接受了活动和镇痛治疗,并进行了骨扫描,结果未发现急性问题。进一步检查发现她上臂普遍无力。肌酸激酶指标显示超过2000。因此,进行了核磁共振成像(MRI)和肌肉活检。诊断为结节病性肌炎,患者开始使用类固醇治疗。她得以完全康复。该病例强调了在更复杂病例中对罕见疾病的考虑。