牛皮癣性关节炎的X线诊断及其治疗

X-ray diagnosis and treatment of psoriatic arthritis

报告有典型X线改变的牛皮癣性关节炎14例，皮损属寻常型者11例，红皮病型者2例，脓疱型者1例。关节症状皆出现于皮损后，且随皮损的变化而加重或缓解。X线主要表现为远侧指（趾）间关节间隙变窄，关节边缘虫蚀状破坏缺损，末节指骨基底部增生、膨大，而近节或中节指骨远端破坏削尖，从而形成“笔套样”改变。甲粗隆吸收变尖乃至消失，或毛糙不整，呈絮状、胡须状增生膨大。病变进展关节呈骨性强直或因脱位或半脱位而致屈曲畸形。治疗上主要采用保守疗法。

Fourteen cases of psoriatic arthritis with typical radiograpbic findings are reported in this paper. Tbey included 11 vulgaris, 2 erythoderma and onepustular psoriases. All the symptoms of the joint appeared after skin rashes, and may be exacerbated or remitted with the changes of efflores-cences. The main X-ray findings included: (1) narrowed space of the distai interphalangeal joint ；(2) vermiform destruction and defect in the jointmargin；(3) proliferation and enlargement of the ungual phalangeal base ；(4) distal destruction and sharpness of the prima or secunda phalange,thus forming a 'pencil cap' deformity；(5) either absorption sharpness and even disappearance, or coarse, fIocculent and beard-like proliferationand enlargement of tuberositas unguicularis. Bony ankylosis or flexion deformity due to dislocation or subluxation may appear in case of progres-sive-stage lesion, The conservative treatment is taken as the main therapy for this disease.