关节病型银屑病的临床特点与X线表现

Clinical and radiological features of psoriasis arthropathica

目的 : 探讨银屑病性关节炎 (PA)的临床特点与X线表现。方法 : 对 32例银屑病性关节炎的临床资料进行统计分析。结果 : 18例皮损先于关节炎出现 ,4例皮损和关节症状同时发生 ,关节炎先发者 10例。 2 2例伴指趾甲损害。不对称少关节炎型 14例 ;脊椎炎型 2例 ;远端指 (趾 )关节炎型 2例 ;对称多关节炎型 13例 ;掌跖脓疱病伴胸锁骨关节炎型 1例。共 30例患者接受X线检查 ,2 0例有PA的X线征。其中远端小关节受累 12例 ( 40 % ) ,膝关节 8例 ( 2 6 .7% ) ,踝关节 6例 ( 2 0 % )。结论 : 远端指 (趾 )关节受累是PA的特征性表现。采用小剂量类固醇激素、环孢素、甲氨蝶呤、依曲替酯等联合用药 。

Objective:To assess the clinical and radiological features of psoriasis arthropathica (PA).Method:An analysis on clinical data of 32 patients with CA was made. Results:Among 32 patients, the manifestation of skin lesions was prior to arthritis in 18 cases, the occurrence of arthritis was prior to skin lesions in 10 cases, and both two kinds of symptoms appeared simultaneously in 4 cases. finger nail and toenail involvement was found in 22 cases . As for the type of PA, 14 cases belonged to asymmetrical oligoarthritis, 13 to symmetrical polyarthritis,2 to spinal form of PA, 2 to distal interphalangeal arthritis and 1 case to pustulosis palmopalantaris with osteoarthritis sternoclavicularis . All 30 cases' roentgenograms suggested typical radiological changes of PA in 20 cases. The involvement of various joints in the process of disease as shown on Xray film in order of frequency was :the small joints of hand and foot in 12 cases (40%), Knee joints in 8 cases (26.7%) and ankle joints in 6 cases (20%). Conclusions :Multipe distal interphalangeal involvement was characteristic of PA. Treatment with low doses of corticosteroids,cyclosporine, MTX or etretinate in combination played a definite role in the management of PA. [