Wohlgethan J R, Stilmant M M, Harris J M, Smith H R
Department of Medicine, Boston Veterans Administration Medical Center, MA 02130.
Ann Rheum Dis. 1989 Mar;48(3):250-3. doi: 10.1136/ard.48.3.250.
A case of acute hip pain in rheumatoid arthritis is presented, with synovial membrane findings. A patient with classical rheumatoid arthritis suffered three unusual bouts of sudden, severe but transient hip pain. The hips were clinically normal between these episodes. The clinical picture on two of these occasions strongly suggested septic arthritis. Although the synovial fluid was highly inflammatory, cultures were negative. The synovial membrane showed mild lining cell hyperplasia, vascular congestion, and scattered inflammatory cells, predominantly lymphocytes. These findings were not compatible with either pyogenic infection or longstanding rheumatoid arthritis. The clinical and pathological features of acute non-infectious arthritis of the hip appear to delineate a distinct syndrome.
本文报告一例类风湿关节炎急性髋部疼痛病例，并伴有滑膜检查结果。一名典型类风湿关节炎患者出现三次突发、严重但短暂的髋部疼痛发作。在这些发作期间，髋部临床检查正常。其中两次发作时的临床表现强烈提示为化脓性关节炎。尽管滑膜液具有高度炎症性，但培养结果为阴性。滑膜显示轻度衬里细胞增生、血管充血以及散在的炎症细胞，主要为淋巴细胞。这些发现既不符合化脓性感染，也不符合长期类风湿关节炎。髋部急性非感染性关节炎的临床和病理特征似乎界定了一种独特的综合征。
