Department of Orthopaedic Surgery, Fukushima Prefectural Minami-Aizu Hospital, Fukushima, Japan.
Med Princ Pract. 2013;22(3):307-10. doi: 10.1159/000342826. Epub 2012 Sep 22.
To describe a rare case of remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome caused by gouty arthritis.
A 76-year-old man presented with swelling and pain in the dorsum of feet and hands bilaterally. From the laboratory and radiologic findings, the diagnosis of gout-induced RS3PE syndrome was made. Conservative therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) and intra-articular corticosteroid injection in the wrist joint completely and rapidly resolved all symptoms. The patient was successfully treated with oral administration of NSAIDs and a one-time intra-articular corticosteroid injection in the left wrist joint.
This case demonstrated the importance of considering the possibility of crystal-induced arthritis such as gout and pseudogout, as well as malignant disease, when diagnosing the primary disease responsible for RS3PE syndrome.
描述一例由痛风性关节炎引起的缓解型血清阴性对称性滑膜炎伴凹陷性水肿(RS3PE)综合征的罕见病例。
一名 76 岁男性出现双侧足部和手部背侧肿胀和疼痛。根据实验室和影像学检查结果,诊断为痛风性 RS3PE 综合征。采用非甾体抗炎药(NSAIDs)和关节内皮质类固醇注射进行保守治疗,迅速完全缓解了所有症状。患者成功接受了 NSAIDs 口服治疗和左腕关节一次性关节内皮质类固醇注射治疗。
本例表明,在诊断 RS3PE 综合征的原发性疾病时,应考虑到晶体性关节炎(如痛风和假性痛风)以及恶性疾病的可能性。