Krajnc I
Abteilung für Innere Medizin, Lehrkrankenhauses Maribor, Slowenien.
Acta Med Austriaca. 1995;22(1-2):25-8.
The 3-year course of treatment of a 35-year old male patient presenting with recurrent afebrile episodes of acute mono- or polyarthritis, periarthritis and at times paraarthritis of the left ankle and knee joint as well as the PIP and MCP joints of the hands is presented. The episodes lasted from a few hours up to several days, leaving no residual changes in the joints. After initial observation and treatment, palindromic rheumatism was diagnosed. During the second year of treatment, seroconversion from the rheumatoid factor negative to the rheumatoid factor positive arthritis form was established. In the third year of treatment, erosions of cartilage and bone in the left knee joint were confirmed radiologically. On the basis of the clinical picture, laboratory findings and radiologic changes in the joints, the diagnosis of erosive seropositive rheumatoid arthritis was made. The author stresses that the diagnosis "palindromic rheumatism" could be established sooner and more often, particularly if, regarding the typical clinical course and history, the possibility of this disease were taken into consideration at all.
本文介绍了一名35岁男性患者的3年治疗过程。该患者反复出现急性单关节炎或多关节炎、关节周围炎，有时还出现左踝关节和膝关节以及手部近端指间关节和掌指关节的关节旁炎，无发热症状。发作持续数小时至数天，关节无残留改变。经过初步观察和治疗，诊断为回纹型风湿症。在治疗的第二年，确诊为由类风湿因子阴性关节炎转变为类风湿因子阳性关节炎。在治疗的第三年，放射学检查证实左膝关节软骨和骨质有侵蚀。根据临床表现、实验室检查结果和关节的放射学改变，诊断为侵蚀性血清阳性类风湿关节炎。作者强调，“回纹型风湿症”的诊断可以更早、更频繁地确立，特别是如果根据典型的临床病程和病史，充分考虑到这种疾病的可能性。
