指（趾）炎：对临床实践的影响
Dactylitis: implications for clinical practice.
作者信息
Rothschild B M, Pingitore C, Eaton M
机构信息
Arthritis Center of Northeast Ohio, Department of Medicine, Northeastern Ohio Universities College of Medicine, Youngstown 44512, USA.
出版信息
Semin Arthritis Rheum. 1998 Aug;28(1):41-7. doi: 10.1016/s0049-0172(98)80027-9.
OBJECTIVES
To assess the specificity of dactylitis for the diagnosis of spondyloarthropathy, sarcoidosis, and gout; and to characterize dactylitis specifically associated with gout.
METHODS
Dactylitis was prospectively assessed among all individuals presenting to the Arthritis Center of Northeast Ohio from 1986 to 1996.
RESULTS
Dactylitis was observed in 12% of individuals with spondyloarthropathy, 17% with sarcoidosis, and 5% with gout, but not in 96 patients with rheumatoid arthritis or in 2,434 patients with osteoarthritis, neck or back pain, or collagen vascular diseases. Among individuals with spondyloarthropathy, dactylitis was present in 22% with psoriatic, 28% with Reiter's syndrome, and only 7% with undifferentiated spondyloarthropathy. Gouty dactylitis was found only in individuals with polyarticular disease.
CONCLUSIONS
Dactylitis is a valuable clue in the differential diagnosis of arthritis. Compared with the wider spectrum in children, sausage-shaped digits have only a few known causes in adults: Reiter's syndrome, psoriatic arthritis, sarcoidosis, flexor tendon sheath infections, and gout. In our series, the presence of dactylitis eliminated rheumatoid arthritis from the differential diagnosis.
目的
评估指（趾）炎对脊柱关节病、结节病和痛风诊断的特异性；并对与痛风特异性相关的指（趾）炎进行特征描述。
方法
对1986年至1996年到俄亥俄州东北部关节炎中心就诊的所有个体进行前瞻性指（趾）炎评估。
结果
在脊柱关节病患者中，12%观察到有指（趾）炎；结节病患者中为17%；痛风患者中为5%；但在96例类风湿关节炎患者、2434例骨关节炎、颈部或背部疼痛或胶原血管病患者中未观察到指（趾）炎。在脊柱关节病患者中，银屑病关节炎患者中有22%存在指（趾）炎，赖特综合征患者中有28%，未分化脊柱关节病患者中仅7%。痛风性指（趾）炎仅在多关节疾病患者中发现。
结论
指（趾）炎是关节炎鉴别诊断中的一个重要线索。与儿童中更广泛的病因谱相比，成人中腊肠样手指的已知病因较少：赖特综合征、银屑病关节炎、结节病、屈肌腱鞘感染和痛风。在我们的系列研究中，指（趾）炎的存在排除了类风湿关节炎的鉴别诊断。
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