Abstract:
A 10-year-old North Indian boy presented with swelling of multiple joints in his hands for the past 3 years. This swelling involved the small joints of his hands and some restriction of joint movement, without any associated tenderness or morning stiffness. No other joints were symptomatically involved. Prior to visiting our hospital, he had received disease-modifying antirheumatoid drugs for suspected juvenile idiopathic arthritis, without any clinical benefit. On examination, the metacarpophalangeal and interphalangeal joints were nontender but had swelling and flexion deformities. He also had a short stature (below the third centile) for his age. Inflammatory markers, including erythrocyte sedimentation rate (7 mm per hour; normal range, 0-22 mm per hour) and C-reactive protein level (1.5 mg/L; normal level, <10 mg/L), were normal, and the rheumatoid factor test result was negative. A skeletal survey of the patient was performed and is shown in Figures 1-6.
摘要:
方法:一名10岁的北印度男孩在过去的3年中出现双手多个关节肿胀。这种肿胀涉及他的手的小关节和关节运动的一些限制,没有任何相关的压痛或晨僵。没有其他关节有症状。在参观我们医院之前,他接受了治疗疑似幼年特发性关节炎的抗类风湿药物,没有任何临床益处。在检查中,掌指关节和指间关节无触痛,但有肿胀和屈曲畸形。他的年龄也很矮小(低于第三百分位)。炎症标志物,包括红细胞沉降率(7毫米/小时;正常范围,每小时0-22毫米)和C反应蛋白水平(1.5毫克/升;正常水平,<10mg/L),是正常的,类风湿因子检测结果为阴性。对患者进行骨骼检查,如图1-6所示。