1病例介绍1.1首次住院情况患者,男,50岁。以多关节相继肿痛僵1年,于2011年6月15日入院。1年前无明显原因双膝痛,不肿,屈伸无明显受限,右手近端指关节、掌指关节痛僵,轻度肿胀,握拳受限。手麻夜间明显,影响睡眠,摆动手部后可好转。在当地按腕管综合征行局部注射治疗2次症状缓解。3个月前牙痛,静脉滴注先锋霉素加地塞米松(10 mg/d),共5 d。停药后双膝疼痛加重,左膝肿胀,右手指关节肿痛,双肩、双髋痛僵,穿脱衣不能,行走跛,右手麻木加 1 case description 1.1 first hospitalization patients, male, 50 years old. Multi-joint swelling and pain after another 1 year, on June 15, 2011 admitted. A year ago, no obvious reason for knee pain, no swelling, no significant limitation of flexion and extension, right proximal knuckle, metacarpophalangeal joint stiffness, mild swelling, fist restriction. Ma hand night significantly, affecting sleep, hand swing can be improved. In the local carpal tunnel syndrome by local injection treatment 2 times to relieve symptoms. 3 months before toothache, intravenous cephalosporin plus dexamethasone (10 mg / d) for 5 days. Pain after knees pain, left knee swelling, swelling of the right finger joint, shoulders, double hip pain, wear undressing, walking lame, numbness of the right hand plus