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[竞技运动中衣原体感染后感染后反应性关节炎:临床管理与当前文献综述]

[Postinfectious reactive arthritis after chlamydia infection in competitive sports : Clinical management and current literature review].

作者信息

Klingebiel Sebastian, Rieger Horst, Gosheger Georg, Theil Jan Christoph, Rickert Carolin, Schneider Kristian Nikolaus

机构信息

Klinik für Allgemeine Orthopädie und Tumororthopädie, Universitätsklinikum Münster, Albert-Schweitzer Campus 1, 48149, Münster, Deutschland.

Klinik für Unfallchirurgie, Orthopädie, Handchirurgie und Sportmedizin, Clemenshospital Münster, Münster, Deutschland.

出版信息

Orthopade. 2021 Mar;50(3):179-187. doi: 10.1007/s00132-020-03935-3.

Abstract

BACKGROUND

Reactive arthritis following infection with chlamydia is a rare but important differential diagnosis in atraumatic joint swelling. A delayed diagnosis often leads to prolonged periods of absence from physical activity. This can have serious consequences, especially for the career of competitive athletes.

OBJECTIVES

Recommendation for the clinical management of postinfectious reactive arthritis for rapid diagnosis and targeted treatment in the symptomatic clinical course.

MATERIALS AND METHODS

Review of the literature on the topics "chlamydia", "reactive arthritis", "postinfectious arthritis" and "sexually acquired reactive arthritis", including presentation of two clinical cases of postinfectious reactive arthritis after chlamydia infection from competitive sports.

RESULTS AND CONCLUSION

Reactive arthritis following chlamydia infection in competitive athletes is a rare entity. However, it can be accompanied by far-reaching individual consequences, especially with regard to possible downtime in sports. Long-term consequences such as chronic joint damage in maintained synovitis must also be considered. In order to make a diagnosis, a specific anamnesis and the direct detection of the pathogen in the specimen of synovial fluid by polymerase chain reaction is essential. This allows a reliable diagnosis to be made with immediate initiation of therapy. However, a prolonged course of the disease cannot be excluded even if therapy is started in due time.

摘要

背景

衣原体感染后反应性关节炎是无创伤性关节肿胀中一种罕见但重要的鉴别诊断。诊断延迟往往导致长时间无法进行体育活动。这可能会产生严重后果,尤其是对竞技运动员的职业生涯而言。

目的

为感染后反应性关节炎的临床管理提供建议,以便在有症状的临床过程中进行快速诊断和靶向治疗。

材料与方法

回顾关于“衣原体”“反应性关节炎”“感染后关节炎”和“性传播反应性关节炎”等主题的文献,包括呈现两例竞技体育中衣原体感染后感染后反应性关节炎的临床病例。

结果与结论

竞技运动员衣原体感染后反应性关节炎是一种罕见病症。然而,它可能会带来深远的个体影响,尤其是在可能的运动停工期方面。还必须考虑诸如持续性滑膜炎导致慢性关节损伤等长期后果。为了做出诊断,详细的病史询问以及通过聚合酶链反应在滑液样本中直接检测病原体至关重要。这使得能够做出可靠诊断并立即开始治疗。然而,即使及时开始治疗,也不能排除疾病病程延长的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b6c/7925465/319b2f23a497/132_2020_3935_Fig1_HTML.jpg

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