原发性肥大性骨关节病一例并文献复习

A case of primary hypertrophic osteoarthropathy with literature review

目的提高临床医生对原发性肥大性骨病的认识。方法报道1例原发性肥大性骨病，对其患者的临床表现、实验室和辅助检查以及诊治过程进行回顾性分析，并进行疾病相关文献复习。结果患者为男性，无家族史，发病年龄16岁；有杵状指（趾）、皮肤增厚、关节肿胀和多汗，X线示骨皮质增厚、骨膜增生，符合肥厚性骨关节病的诊断；应用少量非甾体抗炎药治疗后关节肿胀症状很快缓解。结论青少年男性出现杵状指（趾）、皮肤增生等表现，应及时进行骨骼X线检查，如有骨皮质增厚，可确定原发性肥大性骨关节病的诊断。

Objective To improve the understanding and diagnosis of primary hypertrophic osteoathropathy（PHO）. Methods A case of PHO was reported. The clinical data and the process of the diagnosis and treatment was analyzed retrospectively, and the related literature were reviewed. Results The patient was a young man without family history of PHO. He had symptoms since age 16. He had clubbing fingers and toes, hypertrophic skin, joint swelling, hyperhidrosis and radiographic evidence of periostitis. Thus the disease was diagnosed as PHO. The patient was treated with NSAIDs and the symptoms relieved very quickly. Conclusion Radiographic examination should be taken in time when young males have the general characters of clubbing fingers and toes, hypertrophic skin changes. If the periostitis presents, the final diagnosis of PHO can be confirmed.