Kenzaka Tsuneaki, Wakabayashi Tetsuji, Morita Yoshinori
Division of General Medicine, Center for Community Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan.
BMJ Case Rep. 2013 Apr 16;2013:bcr2013009239. doi: 10.1136/bcr-2013-009239.
A 68-year-old woman presented with an acute onset of lower abdominal pain. A CT scan of the pelvis showed acute crystal deposition arthritis, and her symptoms markedly reduced with non-steroidal anti-inflammatory drugs. Further, a radiographic evaluation of the right knee joint and CT of the cervical spine revealed calcification; calcium pyrophosphate (CPP) crystals were identified in the synovial fluid of the right knee. This established the diagnosis of CPP crystal deposition disease, while the inflammation of the pubic symphysis was considered as acute crystal deposition arthritis related to calcium pyrophosphate dihydrate crystal deposition. Acute crystal deposition arthritis of the pubic symphysis should be considered in the differential diagnosis of lower abdominal pain.
一名68岁女性因下腹部疼痛急性发作前来就诊。骨盆CT扫描显示为急性晶体沉积性关节炎，使用非甾体抗炎药后她的症状明显减轻。此外，右膝关节的影像学评估和颈椎CT显示有钙化；在右膝滑液中发现了焦磷酸钙（CPP）晶体。这确立了CPP晶体沉积病的诊断，而耻骨联合的炎症被认为是与二水焦磷酸钙晶体沉积相关的急性晶体沉积性关节炎。在鉴别诊断下腹部疼痛时应考虑耻骨联合急性晶体沉积性关节炎。
