CAJ | 학술논문

目的探讨近指间关节周围胶原沉积症的发病机制、诊断和鉴别诊断及临床治疗方法.方法总结2006年至2012年12例近指间关节周围胶原沉积症患者的一般资料、实验室检查结果、关节受累情况、影像学表现及病理学检查结果、采取的治疗方法及随访结果.结果 12例患者临床表现为慢性无痛性近指间关节周围膨大和肿胀,关节活动正常.累及关节呈对称性分布,以示、中、环指近指间关节为主.实验室检查未见异常表现;X线片检查显示关节周围软组织肿胀,无关节和骨质破坏;MRI检查显示关节囊外软组织肿胀明显,关节软骨无破坏,无明显滑膜增厚;病理学特征为真皮层大量胶原纤维沉积.本病呈良性经过,无需特殊治疗,外科手术可改善外观.结论近指间关节周围胶原沉积症发病率低,常不为手外科医生所认识,应与各种可累及近指间关节的关节炎相鉴别,以作出正确的诊断,避免过度治疗.
목적 탐토근지간관절주위효원침적증적발병궤제、진단화감별진단급림상치료방법.방법 총결2006년지2012년12례근지간관절주위효원침적증환자적일반자료、실험실검사결과、관절수루정황、영상학표현급병이학검사결과、채취적치료방법급수방결과.결과 12례환자림상표현위만성무통성근지간관절주위팽대화종창,관절활동정상.루급관절정대칭성분포,이시、중、배지근지간관절위주.실험실검사미견이상표현;X선편검사현시관절주위연조직종창,무관절화골질파배;MRI검사현시관절낭외연조직종창명현,관절연골무파배,무명현활막증후;병이학특정위진피층대량효원섬유침적.본병정량성경과,무수특수치료,외과수술가개선외관.결론 근지간관절주위효원침적증발병솔저,상불위수외과의생소인식,응여각충가루급근지간관절적관절염상감별,이작출정학적진단,피면과도치료.
Objective To study the clinical features,pathogenesis,diagnosis and diferential diagnosis,and treatment options of pachydermodactyly.Methods The clinical data,laboratory test results,joint involvement,image characteristics,pathology interpretations,treatment methods and follow-up results of 12 cases of pachydermodactyly treated between 2006 and 2012 were analyzed.Results There were 10 males and 2 females with a mean age of 14 years.Clinical features included chronic painless swelling and enlargement of the PIP joints.Joint movement was normal.Joint involvement was symmetrical with bilateral 2,3,4 PIP joints most affected.Lab results were all negative.X-ray showed only peri-articular soft tissue swelling without bone and articular damage.MRI showed soft tissue swelling outside the joint capsule with no articular cartilage damage or synovitis.Histopathology showed increased dermal accumulation of collagen fibers.The course of the disease was benign.No treatment was needed except surgeries to improve the aesthetics.Conclusion Pachydermodactyly is an uncommon disease,which is not familiar to most hand surgeons.It should be differentiated from other arthritis involving PIP joints.Correct diagnosis of this disease entity can avoid over treatment.