Masuda I, Ishikawa K
Department of Orthopaedic Surgery, Kumamoto University Medical School, Japan.
Clin Orthop Relat Res. 1988 Apr(229):173-81.
Fifty patients (15 men and 35 women; average age, 70.8 years) with pseudogout were studied. Arthroscopic biopsy was useful for diagnosis in one case with no light microscopic evidence of crystals in the synovial fluid. Attacks affected 93 sites in 50 patients. Attacks in ten patients occurred after mild trauma, long distance walks, total knee arthroplasty, or intraarticular injection of microcrystalline glucocorticoid. Twenty-five patients had fevers averaging 38 degrees. In five patients the fever was associated with mental confusion. Fourteen patients were initially suspected or misdiagnosed as having septic arthritis. Six patients were treated surgically under this misdiagnosis, with synovectomy complicated by limitation of motion of both knees in one patient. The involvement of more than one joint was noted in 21 patients. Polyarthritis could be an important clue to the diagnosis performed early; the combination of arthrocentesis and injection of microcrystalline glucocorticoid provided excellent therapy.
对50例假性痛风患者（15例男性，35例女性；平均年龄70.8岁）进行了研究。关节镜活检对1例滑膜液中无晶体光镜证据的病例诊断有用。发作累及50例患者的93个部位。10例患者的发作发生在轻度创伤、长途行走、全膝关节置换术或关节内注射微晶糖皮质激素之后。25例患者发热，平均体温38度。5例患者发热伴有精神错乱。14例患者最初被怀疑或误诊为化脓性关节炎。6例患者在此误诊情况下接受了手术治疗，其中1例患者行滑膜切除术后双膝活动受限。21例患者存在多个关节受累。多关节炎可能是早期诊断的重要线索；关节穿刺和注射微晶糖皮质激素联合应用提供了良好的治疗效果。
