Benhamou C L, Roux C, Benhamou-Mayoux A, Gauvain J B, Corlieu P, Viala J F, Amor B
Rev Rhum Mal Osteoartic. 1987 Mar;54(3):203-7.
Costo-vertebral and costo-transverse joints are often involved during rheumatoid pelvispondylitis. Their involvement may lead to thoracic ankylosis and decreased respiratory capabilities. These arthritis may also cause intercostal or pseudo-visceral pains. The authors report three cases of lower costo-vertebral arthritis, revealed by pseudo-urological, acute or subacute pains. The diagnosis was made on clinical findings (especially mobilization of the lower ribs) and confirmed by X-Rays (especially tomodensitometry). One of the cases presents an image of unilateral pedicle opacity secondary to costovertebral arthritis. The pseudo-urological manifestation of the pain is likely explained by the anatomical relationship between costo-vertebral joints and the sympathetic communicating rami. This close anatomical relationship was confirmed by dissection. Through the communicating rami, the costo-vertebral joints are thus in relation with the sympathetic system, which is responsible for the sensory innervation of the renal space. The pseudo-urological revelation of this arthritis should be compared to that of costal sprains.
类风湿性骨盆脊柱炎常累及肋椎关节和肋横突关节。这些关节受累可能导致胸椎强直并降低呼吸功能。这些关节炎还可能引起肋间痛或假性内脏痛。作者报告了3例下肋椎关节炎病例，表现为假性泌尿系统急性或亚急性疼痛。诊断基于临床发现（尤其是下肋活动度）并经X线检查（尤其是体层摄影）证实。其中1例病例呈现出肋椎关节炎继发的单侧椎弓根模糊影像。疼痛的假性泌尿系统表现可能由肋椎关节与交感神经交通支之间的解剖关系所解释。这种紧密的解剖关系经解剖得以证实。通过交通支，肋椎关节与交感神经系统相关，而交感神经系统负责肾区的感觉神经支配。这种关节炎的假性泌尿系统表现应与肋部扭伤的表现相比较。
