糖尿病性骨关节病

本文分析七例糖尿病性骨关节病的临床X线表现。本病好发于四肢骨端，尤以跖，趾骨多见。主要的X线征象以骨端骨质吸收破坏为主，骨膜反应和骨质硬化轻微，最后关节面破坏。本病成因与糖尿病的神经病变，血管病变代谢紊乱及合并局部感染等多种因素有关。     

The radiological residua of healed diabetic arthropathies

Diabetic arthropathy is a relatively rare manifestation of neuropathic disease, occurring in fewer than 5% of cases. Abnormalities of this type are confined largely to the small joints of the feet, although the larger joints of the lower limbs and the spine occasionally are affected. Some lesions, particularly in the feet, repair spontaneously, leaving radiological residua sufficiently characteristic to prompt suspicion of an unrecognised diabetic state. These include deformity of the head of the second metatarsal (akin to a Freiberg lesion), shortening of the great toe, painless deforming arthrosis of the knee, and ankylosis of interphalangeal joints. In the presence of these signs the patient should be interrogated concerning diabetes and blood sugar estimates, with provocation if necessary, obtained. Should such a diagnosis be sustained, appropriate protective measures may be undertaken to avoid a relapse of the arthropathy.     

Hypertrophic osteoarthropathy of one leg – a sign of aortic graft infection

We report a rare case of hypertrophic osteoarthropathy (HOA) confined to the right leg secondary to aortic graft infection. The development of HOA exclusively localized to areas distal to a vascular prosthesis may be the presenting manifestation of graft infection and a crucial diagnostic clue in the early detection of vascular graft infection. HOA is diagnosed by its characteristic radiographic and scintigraphic pattern. Most prosthetic, especially aortic, graft infections are uniformly fatal if not treated by aggressive surgical and antibiotic therapy. Recognition of this uncommon association may facilitate an early diagnosis, which usually requires immediate surgical therapy. Received: 16 November 1998 Revision requested: 17 December 1998 Revision received: 11 January 1999 Accepted: 14 January 1999     

Hypertrophic osteoarthropathy in a child with biliary atresia

Hypertrophic osteoarthropathy is a syndrome characterized by clubbing of the digits of the hand/foot, periosteal reaction and arthralgia or arthritis which is usually secondary to cyanotic congenital heart disease and chronic pulmonary infections. This syndrome rarely occurs in association with chronic liver disease in childhood. Here, we report on a child with biliary atresia who developed arthralgia and arthritis during follow‐up and which was diagnosed as hepatic hypertrophic osteoarthropathy. It is emphasized that hypertrophic osteoarthropathy should be considered in the differential diagnosis of arthralgia and arthritis in children with long‐standing chronic liver diseases, especially if finger clubbing is also present.     

温针灸与针刺治疗老年性膝骨关节病的临床疗效对比

目的 探究温针灸与针刺治疗老年性膝骨关节病的临床疗效。方法 选取我院2015年1月~2017年1月收治的老年性膝骨关节病患者110例,按随机数字表法分为实验组和对照组,每组55例。实验组采取温针灸疗法,对照组采取针刺治疗。对比两组患者治疗有效率、治疗前后膝关节评分和疼痛量表评分。结果 实验组治疗有效率为94.55%,高于对照组的74.55%,差异具有统计学意义（P＜0.05）。治疗后1周、2周,实验组膝关节HSS评分均高于对照组,差异具有统计学意义（P＜0.05）。治疗后1周,实验组膝关节ROM评分为（82.24±9.46）分,高于对照组的（75.24±9.32）分,差异具有统计学意义（P＜0.05）;治疗2周,两组膝关节ROM评分对比,差异无统计学意义（P＞0.05）。治疗前后,两组间疼痛量表VAS评分及评分差值对比,差异均无统计学意义（P＞0.05）。结论 与针刺治疗相比,温针灸能在较短时间内缓解患者膝骨关节疼痛,且治疗方式较适宜老年患者。     

36例以杵状指为首发症状的肺癌临床分析

目的探讨杵状指作为肺癌首发症状时的临床特征。方法回顾分析3584例经病理证实的肺癌中36例以杵状指为首发症状者的临床资料。结果以杵状指为首发症状者占全部病例的1．00％;36例中吸烟者占83．3％,鳞癌12例（33．3％）,腺癌21例（58．3％）;7例合并肥大性骨关节病其他表现,占19．4％;根治切除30例,占83．3％;术后杵状指开始消退,可完全恢复正常。结论杵状指可单独或合并肥大性骨关节病其他表现出现作为肺癌的首发症状,应在全面考虑和详尽检查后作出诊断。     

Hypertrophic osteoarthropathy in two children with cholestatic hepatic disease

AIM: To describe two children with hypertrophic osteoarthropathy associated with cholestatic hepatic disease. Both patients suffered from chronic progressive cholestatic liver disease and developed digital clubbing, polyarthritis and periosteal reaction. In one of them, clinical and radiological features normalized after liver transplant. CONCLUSION: Hepatic hypertrophic osteoarthropathy is a rare disabling condition that responds poorly to conservative management, while liver transplantation appears to be the only effective therapeutic intervention.     

补阳还五汤治疗老年性腰椎骨关节病30例

为探讨补阳还五汤治疗老年性腰椎骨关节病的效果 ,5 7例患者分为治疗组 (30例 ,补阳还五汤加味治疗 )和对照组 (2 7例 ,骨刺片治疗 ) ,疗程均为 6周。结果 :治疗组显效 2 3例、有效 6例、无效 1例 ,总有效率 96 6 7% ;对照组显效 16例、有效 5例、无效 6例、总有效率 77 78%。组间比较 ,P <0 0 5 ,治疗组的效果优于对照组     

蜡疗辅助治疗骨关节病 关节功能障碍强直65例疗效观察

目的 :为临床上治疗骨关节病、关节功能强直提供有效的辅助治疗方法。方法 :以蜡饼为主 ,溶化后冷却适中 ,外敷于患处 ,每日 1次 ,每次 30 min,15次为一疗程。结果 :显效 17例 ,有效 4 1例 ,无效 8例。结论 :病人局部僵硬的肌肉得到松弛伸展、疼痛消失、软化松解了疤痕 ,因而我们认为蜡疗是针对骨关节病、关节功能障碍强直有效的辅助治疗方法之一。