[手部侵蚀性关节病。鉴别诊断标准]

[Erosive arthrosis of the hand. Criteria of the differential diagnosis].

作者信息

Scutellari P N, Orzincolo C

出版信息

Radiol Med. 1985 May;71(5):292-7.

Abstract

Erosive osteoarthritis (EOA) is a peculiar form of osteoarthritis, characterized by inflammatory destructive changes (erosions) in the interphalangeal joints, with relative sparing of the metacarpophalangeal joints, and frequent involvement of the trapeziometacarpal joint. Linear periosteal bone apposition is also commonly reported. In EOA, erosions tend to occur exclusively in the subchondral cortex of joints, causing in DIP joints a typical "gull wings" configuration of bones of distal phalanges, whereas in psoriatic arthritis (PA) and in rheumatoid arthritis (RA) the "bare areas" are primarily affected. However, such "gull wings" erosions are nonspecific, and may be observed in the late stage of PA in the IP joints, or RA in the PIP joints.

摘要

侵蚀性骨关节炎（EOA）是骨关节炎的一种特殊形式，其特征是指间关节出现炎症性破坏改变（侵蚀），掌指关节相对较少受累，大多角掌关节常被累及。线性骨膜骨附着也较为常见。在侵蚀性骨关节炎中，侵蚀往往仅发生在关节软骨下皮质，导致远端指间关节的远端指骨出现典型的“海鸥翼”样骨质形态，而在银屑病关节炎（PA）和类风湿关节炎（RA）中，“裸露区域”是主要受累部位。然而，这种“海鸥翼”样侵蚀并非特异性表现，在银屑病关节炎晚期的指间关节或类风湿关节炎的近端指间关节也可能出现。