Campion G V, McCrae F, Alwan W, Watt I, Bradfield J, Dieppe P A
Department of Medicine, University of Bristol, Bristol Royal Infirmary, England.
Semin Arthritis Rheum. 1988 May;17(4):232-45. doi: 10.1016/0049-0172(88)90009-1.
IDA of the shoulder is a condition found predominantly in elderly females. Although the shoulder is primarily involved, other joints such as the hip and knee can be affected, and concurrent OA is common at other joint sites. Clinical features include voluminous, often blood-stained effusions, together with features of rotator cuff rupture and restriction of shoulder movement. Laboratory parameters are usually normal and examination of the synovial fluid reveals large amounts of basic calcium phosphate crystals. The synovium is hypertrophied and vascular and shows fibrin deposition. It contains calcified material extracellularly. An acute inflammatory infiltrate is absent. Radiographs demonstrate soft tissue swelling and subchondral sclerosis with marked bony attrition involving the acromioclavicular and glenohumeral joints, as well as the humeral head and neck. Although some aspects of the disease seem distinct, many features are shared with other types of destructive arthritis of the shoulder. The pathogenesis of this disorder is at present obscure, but it is clear that an understanding of the processes involved will provide a vital contribution to our understanding of the response of the joint to insult. With a multidisciplinary approach and adequate communication between interested workers this aim could seen be within our grasp.
肩部特发性破坏性关节炎是一种主要见于老年女性的病症。虽然主要累及肩部，但其他关节如髋部和膝部也可能受到影响，并且在其他关节部位并发骨关节炎很常见。临床特征包括大量的、常带血的积液，以及肩袖撕裂和肩部活动受限的特征。实验室指标通常正常，滑膜液检查显示大量碱性磷酸钙晶体。滑膜肥厚且血管丰富，有纤维蛋白沉积。滑膜细胞外含有钙化物质。无急性炎症浸润。X线片显示软组织肿胀和软骨下硬化，伴有肩锁关节和盂肱关节以及肱骨头和颈部的明显骨质磨损。尽管该疾病的某些方面似乎有其独特之处，但许多特征与其他类型的肩部破坏性关节炎相同。目前这种病症的发病机制尚不清楚，但很明显，了解其中涉及的过程将对我们理解关节对损伤的反应做出重要贡献。通过多学科方法以及相关研究人员之间的充分沟通，这一目标有望实现。
