Pavelka K
Z Rheumatol. 1979 Mar-Apr;38(3-4):90-8.
Joint symptoms in sarcoidosis are early manifestations of this systemic disease; patients with such symptoms, however, are seldom examined by a rheumatologist. The authors investigated 72 patients in whom a definite diagnosis of sarcoidosis had been made at the 1. University Clinic for Tuberculosis and Respiratory Diseases. Joint symptoms were found in 75% of the patients. In those with erythema nodosum they were found in 94%. Acute onset of the disease was found in more than 50% of the patients with erythema nodosum. Objective joint abnormalities were noted in 28% of the patients without erythema nodosum and in 67% of the patients with erythema nodosum. The talocrural joints were most frequently affected (32%). The laboratory investigations included the erythrocyte sedimentation rate, mucoprotein-tyrosin, blood calcium, uric acid, gamma globulin levels, latex fixation test, the Waaler-Rose hemagglutination test and alkaline phosphatase. The results of the laboratory tests and of the clinical findings were compared with those already published. Sarcoidosis is always a possible diagnosis in mono-and oligarticular arthritides of the talocrural joints in middle aged patients, particularly in women with erythema nodosum. The diagnosis is confirmed by enlargement of the hilar lymph nodes on CXR and by a negative tuberculin reaction.
结节病的关节症状是这种全身性疾病的早期表现;然而,有此类症状的患者很少由风湿病学家进行检查。作者对在1. 大学结核病和呼吸疾病诊所确诊为结节病的72例患者进行了调查。75%的患者出现关节症状。在患有结节性红斑的患者中,这一比例为94%。超过50%的结节性红斑患者疾病急性起病。在无结节性红斑的患者中,28%出现客观关节异常,在有结节性红斑的患者中,这一比例为67%。距小腿关节最常受累(32%)。实验室检查包括红细胞沉降率、粘蛋白 - 酪氨酸、血钙、尿酸、γ球蛋白水平、乳胶凝集试验、瓦勒 - 罗斯血凝试验和碱性磷酸酶。将实验室检查结果和临床发现与已发表的结果进行了比较。对于中年患者,尤其是患有结节性红斑的女性,距小腿关节单关节和少关节关节炎时,结节病始终是一种可能的诊断。通过胸部X线片上肺门淋巴结肿大和结核菌素反应阴性来确诊。