Esposito P W, O'Malley D, Litaker D
Department of Orthopaedic Surgery & Rehabilitation, University of Nebraska Medical Center, Omaha.
Orthop Rev. 1988 Mar;17(3):295-9.
An 80-year-old man presented with an acute, rapidly worsening synovitis with a hot effusion of the right knee approximately 48 hours following a urologic procedure. Initial aspirates failed to reveal crystals and suggested an acute infectious arthritis. Because his course continued to deteriorate despite adequate antibiotic treatment, the patient underwent arthroscopy in order to place tubes and to effect adequate irrigation and debridement. The preoperative diagnosis was septic arthritis. At the time of arthroscopy, there was gross evidence of crystals that were subsequently diagnosed as calcium pyrophosphate. This case illustrates the importance of an adequate differential diagnosis and the usefulness of the arthroscope in obtaining adequate tissue and aspirate under confusing circumstances.
一名80岁男性在接受泌尿外科手术后约48小时，出现急性、迅速加重的滑膜炎，右膝关节有发热积液。最初的关节穿刺未能发现晶体，提示为急性感染性关节炎。尽管给予了充分的抗生素治疗，但其病情仍持续恶化，因此患者接受了关节镜检查，以便放置引流管并进行充分的冲洗和清创。术前诊断为化脓性关节炎。关节镜检查时，肉眼可见晶体，随后诊断为焦磷酸钙。该病例说明了进行充分鉴别诊断的重要性，以及关节镜在复杂情况下获取足够组织和穿刺液的实用性。
