Bird H A, Tribe C R, Bacon P A
Ann Rheum Dis. 1978 Jun;37(3):203-11. doi: 10.1136/ard.37.3.203.
We have reviewed 21 adults referred to rheumatology clinic and considered to have generalised joint hypermobility by the criteria of Carter and Wilkinson (1964), modified by Beighton et al. (1973). They fell into two categories. 5 patients had a raised plasma viscosity (PV) and in each case a definite pathology was found to account for this, superimposed on hypermobile joints. The remaining 16 had a normal PV and this group was thought to represent the late natural history of hypermobility. 5 of these (aged 32 to 54 years) had no evidence of osteoarthrosis but the remaining 11 (aged 34 to 80 years) had widespread radiological osteoarthrosis. Synovial histology was obtained at arthroscopy in 6 of these patients and 4 (aged 60 to 75) had chondrocalcinosis. This previously undescribed finding may be the end result of hypermobile joints. Hypermobile patients with joint deformity (lax connective tissue), widespread synovial thickening (traumatic), and hot joint effusions (chondrocalcinosis) may mimic rheumatoid arthritis. They must be distinguished from patients who develop rheumatoid arthritis in hypermobile joints.
我们回顾了21名转诊至风湿病诊所的成年人,这些人根据卡特和威尔金森(1964年)的标准,并经比顿等人(1973年)修改后,被认为具有全身关节活动过度。他们分为两类。5名患者血浆粘度(PV)升高,在每种情况下都发现了明确的病理情况来解释这一现象,这些病理情况叠加在关节活动过度的关节上。其余16名患者PV正常,这一组被认为代表了关节活动过度的晚期自然病程。其中5名患者(年龄在32至54岁之间)没有骨关节炎的证据,但其余11名患者(年龄在34至80岁之间)有广泛的放射性骨关节炎。在其中6名患者的关节镜检查中获取了滑膜组织学样本,4名患者(年龄在60至75岁之间)有软骨钙质沉着症。这一先前未被描述的发现可能是关节活动过度的最终结果。伴有关节畸形(结缔组织松弛)、广泛滑膜增厚(创伤性)和热关节积液(软骨钙质沉着症)的关节活动过度患者可能会模仿类风湿关节炎。他们必须与在关节活动过度的关节中发生类风湿关节炎的患者区分开来。