Brinkman Joseph C, McQuivey Kade S, Makovicka Justin L, Bingham Joshua S
Department of Orthopedics, Mayo Clinic in Arizona, Phoenix, Arizona, USA.
Case Rep Orthop. 2020 Mar 24;2020:7613627. doi: 10.1155/2020/7613627. eCollection 2020.
We present a case of an 82-year-old female with a history of right total knee arthroplasty 11 years prior. She was admitted after a ground-level fall and developed progressive pain and swelling of her right knee. She had no history of complications with her total knee replacement. Radiographs of the knee and hip were negative for acute fracture, dislocation, or hardware malalignment. Knee aspiration was performed and revealed inflammatory exudate, synovial fluid consistent with crystal arthropathy, and no bacterial growth. She was diagnosed with an acute gout flare, and her symptoms significantly improved with steroids and anti-inflammatory treatment. Orthopedic surgeons should be aware of the potential for crystal arthropathy in the setting of total joint arthroplasty and evaluate for crystals before treating a presumed periprosthetic joint infection.
我们报告一例82岁女性病例，其11年前有右全膝关节置换术史。她在一次平地跌倒后入院，随后出现右膝进行性疼痛和肿胀。她的全膝关节置换术没有并发症病史。膝关节和髋关节的X线片显示无急性骨折、脱位或内固定物排列不齐。进行了膝关节穿刺，结果显示有炎性渗出物、与晶体性关节病相符的滑液，且无细菌生长。她被诊断为急性痛风发作，使用类固醇和抗炎治疗后症状明显改善。骨科医生应意识到在全关节置换的情况下存在晶体性关节病的可能性，并在治疗假定的假体周围关节感染之前评估是否存在晶体。
