Aufdermaur M, Köchli H
Schweiz Med Wochenschr. 1977 Mar 12;107(10):342-6.
The clinical course and radiologic and serologic findings are reported in 37 subjects who, during the years 1954 to 1974, had rheumatoid nodules removed and examined histologically. The observations were classified into four groups according to a system similar to that of Steinbrocker. The histological findings were the same in all four groups. In 4 subjects the diagnosis of rheumatoid arthritis was established by the biopsy. In 5 additional patients the histologic examination confirmed the clinical diagnosis. Radiologically the joints of 5 adults were unremarkable while those of 14 subjects had developed slight or moderate changes, and in 18 patients advanced destruction or deformities or ankylosis were present. In instances of marked joint destruction the course of the disease may, spontaneously or after appropriate treatment, become bland. 90% of our patients were seropositive and 10% seronegative. 9 subjects had temporarily low RF serum titers. Serologic data are of value for the differential diagnosis of joint diseases. They are not, however decisive.
报告了1954年至1974年间37例切除类风湿结节并进行组织学检查的患者的临床病程、放射学和血清学检查结果。根据与斯坦布罗克(Steinbrocker)系统类似的方法,将观察结果分为四组。四组的组织学检查结果相同。4例患者经活检确诊为类风湿关节炎。另有5例患者的组织学检查证实了临床诊断。放射学检查显示,5名成年人的关节无明显异常,14名患者的关节有轻微或中度变化,18名患者出现了严重破坏、畸形或关节强直。在关节严重破坏的情况下,疾病进程可能会自发或在适当治疗后趋于平稳。我们的患者中90%血清学呈阳性,10%血清学呈阴性。9名患者的类风湿因子(RF)血清滴度暂时较低。血清学数据对关节疾病的鉴别诊断有价值。然而,它们并非决定性因素。