Shimizu Takashi, Akita Shosuke, Harada Yoshinori, Oguro Eri, Okita Yasutaka, Shigesaka Minoru, Matsuoka Hidetoshi, Nii Takuro, Teshigawara Satoru, Kudo-Tanaka Eriko, Tsuji Soichiro, Matsushita Masato, Ohshima Shiro, Hoshida Yoshihiko, Hashimoto Jun, Saeki Yukihiko
Department of Rheumatology and Allergology, Osaka Minami Medical Center, Japan.
Department of Orthopedic Surgery, Osaka Minami Medical Center, Japan.
Intern Med. 2017;56(10):1243-1246. doi: 10.2169/internalmedicine.56.7912. Epub 2017 May 15.
A 72-year-old man presented with persistent oligoarthritis and positive results for rheumatoid factor and was suspected of having rheumatoid arthritis (RA). However, the musculoskeletal ultrasonography (MSUS) findings were not consistent with those of typical RA. He had undergone surgery for carpal tunnel syndrome, which allowed both histopathological and microbiological examinations to be performed. A synovial tissue culture was positive for Sporothrix schenckii, and he was diagnosed with sporotrichal tenosynovitis. He received anti-fungal therapy, and the sporotrichal tenosynovitis resolved. This case suggests that MSUS is a useful modality, and sporotrichal tenosynovitis, though rare, should be considered in the differential diagnosis of RA.
一名72岁男性因持续性少关节炎、类风湿因子检测结果呈阳性而被怀疑患有类风湿关节炎（RA）。然而，肌肉骨骼超声检查（MSUS）结果与典型RA不符。他曾接受过腕管综合征手术，这使得组织病理学和微生物学检查得以进行。滑膜组织培养显示申克孢子丝菌阳性，他被诊断为孢子丝菌性腱鞘炎。他接受了抗真菌治疗，孢子丝菌性腱鞘炎得以缓解。该病例表明，MSUS是一种有用的检查方法，虽然孢子丝菌性腱鞘炎罕见，但在RA的鉴别诊断中应予以考虑。
