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患者,女,37岁。因四肢关节疼痛3年,加重2月于1992年9月18日入院。患者于3年前开始受潮湿后出现关节疼痛,从近端指关节开始,逐渐波及腕关节和肩关节。肘、膝、踝和颈关节也出现受累表现,其中肩关节活动受限最为明显,两上肢无法上抬上举,两手不能握拳,手指经常保持在半屈半伸位置。近两月膝踝关节出现肿胀,不能离床下蹲,生活无法自理。四肢活动受限,尤以双手、肘、肩、膝、踝处明显,并于膝踝关节处可见中度肿胀,颈部及下颌活动也受限。实验室检查ESR 52mm/1h,ASL-O1:800,RF(+);HBsAg S/M<2.1,IgG10.45g/L,IgA2.02g/L,IgM2.25g/L,CIC0.807OD/nm(正常为0.08±0.03OD/nm)。颈椎、手、膝等关节x光片未见病变。
Patient, female, 37 years old. Due to limb pain in joints for 3 years, increased in February on September 18, 1992 admission. Patients developed joint pain when they began to damp three years ago, beginning with the proximal knuckles and gradually affecting the wrists and shoulders. Elbow, knee, ankle and neck joints also showed involvement, of which the most obvious limitation of shoulder activity, the two upper limbs can not be lifted on the move, both hands can not make a fist, fingers often remain in half flexion position. Knee and ankle swelling in recent two months, can not squat from bed, life can not take care of themselves. Extremity activity is limited, especially hands, elbows, shoulders, knees, ankle was significant, and moderate to moderate swelling in the knee and ankle joints, neck and jaw activity is also limited. Laboratory tests ESR 52mm / 1h, ASL-O1: 800, RF (+); HBsAg S / M <2.1, IgG10.45g / L, IgA2.02g / L, IgM2.25g / L, CIC0.807OD / Normal 0.08 ± 0.03 OD / nm). Cervical spine, hands, knees and other joint x-ray films no lesions.