牛皮癣性关节炎误诊35例X线分析

目的 提高对牛皮癣性关节炎的认识,寻找牛皮癣性关节炎的X线征象特点作鉴别诊断.方法 选择经临床确诊的具有典型牛皮癣皮肤病变的牛皮癣性关节炎患者,拍摄足部正、侧、斜位平片,分析牛皮癣性关节炎的X线表现及影像特点.结果 通过X线影像分析,牛皮癣性关节炎的突出表现在掌指和跖趾关节的病变.X线表现为远端掌指关节或跖趾关节间隙狭窄,关节面可有虫蚀样骨质破坏缺损,末节指或趾骨近端有不规则骨增生并呈杯状膨大,末端骨质可吸收变尖变细,甚至消失,重者关节强直,病理性脱位,屈曲畸形.结论 牛皮癣性关节炎临床发病率低,往往易忽视,易误诊误治,造成关节病变进一步恶化,通过对牛皮癣性关节炎的X线影像分析,可寻找到牛皮癣性关节炎与其它关节炎在X线影像上的不同点,结合临床,对牛皮癣性关节炎的诊断不难.

X-ray Analysis of Misdiagnosis in 35 Cases of Psoriatic Arthritis

Objective To improve the recognition of psoriatic arthritis, search the X-ray signs characteristics of psoriatic arthritis for diagnosis. Methods Confirmed psoriatic arthritis patients with typical psoriasis dermatopathy were choosed to take pictures of feet fi＇ontal, lateral and oblique plain films; analysed the X-ray performance and image characteristic of psoriatic arthritis. Results The distinct manifestations of psoriatic arthritis were the lesion in metacarpophalangeal and metatarsophalangeal joints. The performance of X-ray were the stenosis of distal metacarpophalangeal joints or metatarsophalangeal joints, the mouse nibbled bone destruction in articular surface, irregular bone proliferation with cotyliform intumescence in distal seg mentor finger and proximal phalanx, the end absorbtion became sharp and attenuation even disappeared, arthroeleisis, pathological dislocation and flexiondeformity happened in severe patients. Conclusion Psoriatic arthritis has low incidence in clinic, and is easy to be ignored, misdiagnosed and mistreated, causing further deterioration. It＇s not difficult to diagnose the psoriatic arthritis through the X-ray image analysis to search the differentia between other kinds of arthritis.