99例SAPHO综合征的临床表现和误诊原因分析

目的 熟悉SAPHO综合征的临床表现和分析其误诊原因,提高对SAPHO综合征的诊断水平。 方法 根据2012年Nguyen等在《Semin Arthritis Rheum》中提出的诊断标准,收集2004年1月~2014年7月门诊及住院的SAPHO综合征99例患者,回顾分析其一般情况、临床表现、实验室检查、影像学及有创操作及手术。 结果 99例患者中误诊掌跖脓疱病32例、肋软骨炎16例、关节炎12例、强直性脊柱炎7例、肩周炎6例、骨结核5例、腰椎间盘突出5例、慢性骨髓炎4例,疑似骨肿瘤4例、颈椎病2例,类风湿关节炎、无菌性骨炎、反应性关节炎、下颌骨炎、代谢性骨病、致密性骨炎各1例。 结论 熟悉SAPHO综合征的临床表现特点和影像学特征,掌握本病的诊断标准,尽早完善骨扫描,是较少误诊率和提高诊断率的关键,从而减少不必要的有创操作及手术。

Clinical Manifestation and Misdiagnosis Analysis of 99 Cases of SAPHO Syndrome

Objective This paper analyzes the reasons of misdiagnosis of SAPHO syndrome, and aims to improve the level of clinical knowledge of SAPHO syndrome and diagnosis. Methods Ninty-nine SAPHO syndrome patients were collected between January 2004 and July 2014 in our hospital. Their general situations were retrospectively analyzed including clinical manifestations, laboratory examination, imaging features, invasive operation and operation. Results Ninty-nine definite diagnosed cases were retrospectively analyzed,of whem 32 cases were misdiagnosed as palmoplantarpustular, 16 cases as rib cartilage inflammation, 12 cases as arthritis, 7 cases as ankylosing spondylitis, 6 cases as periarthritis of shoulder, 5 cases as bone tuberculosis, 5 cases as prolapse of lumbar intervertebral disc, 4 cases as chronic osteomyelitis, 4 cases as suspected bone tumors,2 cases as cervical spondylosis, 1 case as rheumatoid arthritis, aseptic osteitis, reactive arthritis, mandibular inflammation, metabolic bone disease, condensing osteitis respectively. Conclusion Familiar with the clinical features and diagnositic criteria of SAPHO syndrome and early bone scan can improve the diagnosis of the disease, reduce unnecessary invasive operation and operation.