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伴有焦磷酸钙的腕关节结核

Tuberculosis of the Wrist Accompanied with Calcium Pyrophosphate.

作者信息

Watanabe Kenya, Yamazaki Yoshitaka, Sugawara Mariko

机构信息

Department of Orthopedics, Nagano Prefectural Suzaka Hospital, Japan.

Department of Infectious Diseases, Nagano Prefectural Suzaka Hospital, Japan.

出版信息

Intern Med. 2017 Dec 15;56(24):3389-3394. doi: 10.2169/internalmedicine.8959-17. Epub 2017 Oct 11.

DOI:10.2169/internalmedicine.8959-17
PMID:29021467
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5790734/
Abstract

This is a rare case of tuberculosis (TB) complicated with pseudogout of the wrist joint in a non-immunocompromised 84-year-old female with a history of pulmonary tuberculosis. She was diagnosed with extrapulmonary tuberculosis of the wrist based on a polymerase chain reaction (PCR) study and synovial fluid aspiration in which the cytology was positive for acid-fast bacilli. Calcium pyrophosphate was also positive. We must be careful not to miss articular tuberculosis as it may mimic common inflammatory arthritis, such as pseudogout of the wrist. Even if the patient is positive for calcium pyrophosphate, this does not exclude the possibility of articular tuberculosis.

摘要

这是一例罕见的病例，一名84岁无免疫功能低下的女性，有肺结核病史，患肺结核并发腕关节假性痛风。基于聚合酶链反应（PCR）研究及滑膜液抽吸检查（其中细胞学检查显示抗酸杆菌阳性），她被诊断为腕关节肺外结核。焦磷酸钙检查也呈阳性。我们必须小心，不要漏诊关节结核，因为它可能会模仿常见的炎性关节炎，如腕关节假性痛风。即使患者焦磷酸钙检查呈阳性，也不能排除关节结核的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e4/5790734/d363c488d34e/1349-7235-56-3389-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e4/5790734/4fa8b4eb11b7/1349-7235-56-3389-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e4/5790734/f740a1553447/1349-7235-56-3389-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e4/5790734/7f115668c855/1349-7235-56-3389-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e4/5790734/cf5c0b5745cd/1349-7235-56-3389-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e4/5790734/d45166c229b4/1349-7235-56-3389-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e4/5790734/5ecb1e177378/1349-7235-56-3389-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e4/5790734/ce8eaf45989f/1349-7235-56-3389-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e4/5790734/d363c488d34e/1349-7235-56-3389-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e4/5790734/4fa8b4eb11b7/1349-7235-56-3389-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e4/5790734/f740a1553447/1349-7235-56-3389-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e4/5790734/7f115668c855/1349-7235-56-3389-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e4/5790734/cf5c0b5745cd/1349-7235-56-3389-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e4/5790734/d45166c229b4/1349-7235-56-3389-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e4/5790734/5ecb1e177378/1349-7235-56-3389-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e4/5790734/ce8eaf45989f/1349-7235-56-3389-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e4/5790734/d363c488d34e/1349-7235-56-3389-g008.jpg

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The anti-cyclic citrullinated peptide response in tuberculosis patients is not citrulline-dependent and sensitive to treatment.结核病患的抗环瓜氨酸肽反应并非依赖瓜氨酸且对治疗敏感。
Arthritis Res Ther. 2010;12(1):R12. doi: 10.1186/ar2913. Epub 2010 Jan 25.
3
Tuberculous extensor tenosynovitis of the wrist with extensor pollicis longus rupture: a case report.
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J Med Case Rep. 2009 Nov 20;3:142. doi: 10.1186/1752-1947-3-142.
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Tuberculosis of the hand: clinical presentation and functional outcome in 32 patients.手部结核：32例患者的临床表现及功能结局
J Bone Joint Surg Br. 2009 Aug;91(8):1054-7. doi: 10.1302/0301-620X.91B8.22074.
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[Tuberculous arthritis of the wrist: a case report].[腕关节结核性关节炎：一例报告]
Chir Main. 2009 Sep;28(4):243-6. doi: 10.1016/j.main.2009.04.006. Epub 2009 May 23.
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Does the presence of crystal arthritis rule out septic arthritis?晶体性关节炎的存在能否排除感染性关节炎？
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