SAPHO综合征患者就医行为及误诊原因分析

目的 分析SAPHO综合征患者的临床特征、就医行为及误诊原因,提高SAPHO综合征的临床诊治水平.方法 对2013年6月—2020年11月收治的32例SAPHO综合征的临床资料进行回顾性分析.结果 32例SAPHO综合征平均年龄为45.25岁,平均病程为100.16个月,皮肤(96.88％)、脊柱(65.62％)、骨(...

Analysis of the Behavior of Seeking Medical Care and the Causes of Misdiagnosis in Patients with SAPHO Syndrome

Objective To analyze the clinical characteristics,behavior of seeking medical care and causes of misdiagnosis in patients with SAPHO syndrome so as to improve clinical diagnosis and treatment of SAPHO syndrome.Methods Clinical data of 32 patients with SAPHO syndrome admitted between June 2013 and November 2020 was retrospectively analyzed.Results The average age of 32 patients with SAPHO syndrome was 45.25 years,and the average course of disease was 100.16 months.Skin(96.88%),spine(65.63%),bone(37.50%)and joints(84.38%)were all affected,and the sternum and sternoclavicular joints were more common in affected bone joints.The proportion of patients with SAPHO syndrome who had visited the Department of Rheumatology for the first time was low.The confirmed time was from 11 d to 24 years,and only 15.62%of patients were confirmed within 3 months,which showed the serious in diagnosis delay.Among 22 patients with bone and joint manifestations initially diagnosed in other departments,21 patients were misdiagnosed as having other diseases,and the misdiagnosed rate was 95.45%.Among 10 patients with skin manifestations initially diagnosed in Department of Dermatology,4 patients were misdiagnosed as having other diseases,and the misdiagnosed rate was 40.00%.The misdiagnosed rate of patients with bone and joint manifestations was significantly higher than that of patients with skin manifestations.After standard anti-inflammatory and immunosuppressive treatment,all patients'conditions were improved,and they were discharged from the hospital.Conclusion The symptoms of patients with SAPHO syndrome are complicated and diverse in clinic,and course of the disease is long delay.The low proportion of initial consultations in Department of Rheumatology,and lack of understanding of the disease by clinicians are important reasons for misdiagnosis.It is necessary to improve understanding of the disease,carefully collect medical histories,perform detailed physical examination and expand diagnostic thinking so as to improve the diagnosed accuracy of SAPHO syndrome.