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超声引导下对一名患有强直性脊柱炎胸柄关节受累患者进行关节内皮质类固醇注射:病例报告

Ultrasound-guided intra-articular corticosteroid injection in a patient with manubriosternal joint involvement of ankylosing spondylitis: A case report.

作者信息

Choi Min-Hee, Yoon In-Young, Kim Won-Joong

机构信息

Department of Anesthesiology and Pain Medicine, Ewha Womans University Mokdong Hospital, Seoul 07985, South Korea.

出版信息

World J Clin Cases. 2023 Mar 26;11(9):2043-2050. doi: 10.12998/wjcc.v11.i9.2043.

Abstract

BACKGROUND

Manubriosternal joint (MSJ) disease is a rare cause of anterior chest pain but can be a major sign of systemic arthritic involvement. In patients with ankylosing spondylitis (AS), a type of systemic arthritis, chest pain can be due to MSJ involvement and can be improved by ultrasound-guided corticosteroid injection into the joint.

CASE SUMMARY

A 64-year-old man visited our pain clinic complaining of anterior chest pain. There were no abnormal findings on lateral sternum X-ray, but arthritic changes in the MSJ were observed on single-photon emission computed tomography-computed tomography. We performed additional laboratory tests, and he was finally diagnosed with AS. For pain relief, we performed ultrasound-guided intra-articular (IA) corticosteroid injections into the MSJ. After the injections, his pain nearly resolved.

CONCLUSION

For patients complaining of anterior chest pain, AS should be considered, and single-photon emission computed tomography-computed tomography can be helpful in diagnosis. In addition, ultrasound-guided IA corticosteroid injections may be effective for pain relief.

摘要

背景

胸柄关节(MSJ)疾病是前胸疼痛的罕见病因,但可能是全身性关节炎累及的主要体征。在强直性脊柱炎(AS)患者中,这是一种全身性关节炎,胸痛可能是由于MSJ受累,通过超声引导下向关节内注射皮质类固醇可缓解疼痛。

病例摘要

一名64岁男性因前胸疼痛就诊于我们的疼痛诊所。侧位胸骨X线检查未见异常,但单光子发射计算机断层扫描-计算机断层扫描显示MSJ有关节炎改变。我们进行了进一步的实验室检查,最终他被诊断为AS。为缓解疼痛,我们对MSJ进行了超声引导下关节内(IA)皮质类固醇注射。注射后,他的疼痛几乎完全缓解。

结论

对于主诉前胸疼痛的患者,应考虑AS,单光子发射计算机断层扫描-计算机断层扫描有助于诊断。此外,超声引导下IA皮质类固醇注射可能对缓解疼痛有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1391/10044947/549913181d73/WJCC-11-2043-g001.jpg

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