Müller W, Bahous I
Bull Schweiz Akad Med Wiss. 1979 Sep;35(4-6):421-42.
The condition of generalized periarthritis calcarea (hydroxyapatite deposition disease) is characterised by multiple periarticular calcification which can be localised around practically any joint and also in proximity to the spine. This calcification consists of hydroxyapatite crystals which are responsible for the episodes of acute, subacute or chronic periarticular or articular inflammation so typical of the condition. Because of this one can classify periarthritis calcarea along with gout and chondrocalcinosis in the group of crystal deposition diseases. The actual cause of the calcification remains unknown but it is probable that, along with hereditary factors, disturbances in metabolism play an important role. The diagnosis of generalised periarthritis is made from the characteristic X-ray picture in conjunction with the clinical findings and, on occasion, the demonstration of hydroxyapatite crystals in the affected tissues. In the differential diagnosis gout, chondrocalcinosis, various inflammatory rheumatic conditions and septic arthritis must be excluded and various calcification processes, particularly interstitial calcinosis and lipocal cinogranulomatosis, must also be considered. Since the etiology of the calcification remains unknown to specific treatment is available. Symptomatic treatment with colchicine is mostly inadequate which is why one often has recourse to the use of non-steroid anti-inflammatory drugs and corticosteroids.
泛发性钙化性关节炎(羟基磷灰石沉积病)的特征是多关节周围钙化,几乎可发生于任何关节周围以及脊柱附近。这种钙化由羟基磷灰石晶体组成,这些晶体是该疾病典型的急性、亚急性或慢性关节周围或关节炎症发作的原因。因此,钙化性关节炎可与痛风和软骨钙质沉着症一起归类为晶体沉积疾病组。钙化的实际原因尚不清楚,但除遗传因素外,代谢紊乱可能起重要作用。泛发性关节炎的诊断依据特征性X线表现结合临床发现,有时还需在受累组织中证实存在羟基磷灰石晶体。在鉴别诊断中,必须排除痛风、软骨钙质沉着症、各种炎性风湿性疾病和化脓性关节炎,还必须考虑各种钙化过程,特别是间质钙化和脂质钙沉着性肉芽肿。由于钙化的病因尚不清楚,目前尚无特效治疗方法。秋水仙碱对症治疗大多效果不佳,这就是为什么人们常常求助于使用非甾体抗炎药和皮质类固醇。