CAJ | 학술논문

目的提高对肥大性骨关节病(HOA)的认识、诊断和鉴别.方法报告我院2例原发性HOA(PHOA)及3例继发性HOA(SHOA)确诊病例,并分析既往国内报道16例文献.结果国内PHOA发病年龄多数在14～24岁,多为男性,最小者1岁起病,最大者为42岁.18例PHOA患者中2例有家族史,2例有近亲结婚史,所有患者均有杵状指(趾)、皮肤增厚粗糙、骨膜增生的临床表现,多汗14例,回状颅皮9例,关节痛和(或)关节积液10例,指(趾)端骨质溶解4例,类风湿因子阳性2例,1例弱阳性.我院报告3例SHOA均继发于肺部肿瘤,中年后起病,病程较短.以关节症状及杵状指(趾)为主要表现,面部及皮肤症状少,全身伴随症状多见.结论 PHOA青少年起病多见.男性多,主要表现为杵状指(趾)、皮肤增厚及骨膜反应.与SHOA需从起病年龄、病程及全身伴随症状等方面鉴别.
목적 제고대비대성골관절병(HOA)적인식、진단화감별.방법 보고아원2례원발성HOA(PHOA)급3례계발성HOA(SHOA)학진병례,병분석기왕국내보도16예문헌.결과 국내PHOA발병년령다수재14～24세,다위남성,최소자1세기병,최대자위42세.18례PHOA환자중2례유가족사,2례유근친결혼사,소유환자균유저상지(지)、피부증후조조、골막증생적림상표현,다한14례,회상로피9례,관절통화(혹)관절적액10례,지(지)단골질용해4례,류풍습인자양성2례,1례약양성.아원보고3례SHOA균계발우폐부종류,중년후기병,병정교단.이관절증상급저상지(지)위주요표현,면부급피부증상소,전신반수증상다견.결론 PHOA청소년기병다견.남성다,주요표현위저상지(지)、피부증후급골막반응.여SHOA수종기병년령、병정급전신반수증상등방면감별.
Objective To help clinicians understanding and better diagnosing of hypertrophic osteoarthropathy(HOA).Methods Clinical data of five HOA patients in Jishuitan Hospital were analyzed and the literature were reviewed.Results In 18 patients with primary HOA(PHOA),their age ranged from 14 to 24 years.Seventeen patients were male.Most PHOA occurred in age 1 to 42.Two of them had positive family history.Clubbing fingers,hypertrophic skin changes and radiographic evidence of periostitis were found in all patients.Nine of them had cutis vertices gyrate,14 patients had hyperhydrosis and 10 patients had symmetrical joints swelling.Three secondary HOA (SHOA)patients of our hospital,predominantly manifested as symmetrical joints swelling with mild joint tender and clubbing fingers.There were no skin changes in these 3 patients.Conclusion PHOA predominantly manifests as clubbing fingers.hypertrophic skin changes and periostitis.