Department of Pathophysiology, Yerevan State Medical University Named after Mkhitar Heratsi, Yerevan, Armenia.
Department of Rheumatology, Yerevan State Medical University Named after Mkhitar Heratsi, Yerevan, Armenia.
BMJ Case Rep. 2022 Sep 22;15(9):e250244. doi: 10.1136/bcr-2022-250244.
An otherwise healthy young man was referred to the rheumatologist because of bilateral proximal interphalangeal (PIP) joint enlargements. The main concern was excluding the presence of inflammatory arthritis. Physical examination revealed bilateral PIP finger joints (II-IV) swellings and cutaneous thickenings in adjacent areas. The specificity of this case was the patient who appeared in the physician's room with his violin suitcase pointing to his profession even from the first site. Complete blood count with leucocyte differentials appeared without changes. Radiographics failed to show joint fluid or bony changes. All immunological markers (RF, anti-cyclic citrullinated peptide) and laboratory data (Erythrocyte sedimentation rate, C-reactive protein, etc) were within the reference ranges or negative. After exclusion of rheumatoid and other inflammatory arthritis, and considering the occupation of the patient and demographics the diagnosis of a rare condition-pachydermodactyly was made.
一位看似健康的年轻男性因双侧近端指间关节（PIP）肿大被转介到风湿病医生处。主要关注的是排除炎症性关节炎的存在。体格检查显示双侧 PIP 手指关节（II-IV）肿胀和相邻区域的皮肤增厚。本例的特殊性在于，患者甚至从第一个部位就带着小提琴手提箱来到医生的房间，这暗示了他的职业。白细胞分类计数的全血细胞计数没有变化。影像学检查未显示关节积液或骨改变。所有免疫标志物（RF、抗环瓜氨酸肽）和实验室数据（红细胞沉降率、C 反应蛋白等）均在参考范围内或为阴性。排除类风湿性关节炎和其他炎症性关节炎后，考虑到患者的职业和人口统计学特征，诊断为一种罕见疾病——厚皮骨膜病。
