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女患,48岁,农民.四肢关节肿痛半年.加重1月.外院诊断为“风湿性关节炎”.用“青霉素”,“消炎痛”,“强的松”治疗无效.本院门诊初诊为风湿性关节炎,于1986年5月8日入院。检查:肘、膝关节以下弥漫性浮肿、膝、踝、肘、腕、指趾关节肿大,压痛明显。指呈杵状指,其它均无异常发现。实验室检费:血清:尿酸142.3μmol/L,尿素氮2.5mmol/L、肌酐88.4μmol/L:血沉78mm/h;抗“O”类风湿因子阴性.胸片:左肺下叶后基底段是一“团块状’增高阴影.大小约为5×3cm.四肢骨正位片检查:管状骨弥漫对称性骨膜增生,
Female, 48-year-old farmer. Stroke and joint swelling and pain for six months. Exacerbated in January. Outside the hospital diagnosed as “rheumatoid arthritis.” With “penicillin”, “indomethacin”, “prednisone” treatment ineffective. For rheumatoid arthritis, on May 8, 1986 admission. Check: elbows, diffuse swelling below the knee, knee, ankle, elbow, wrist, toe joint swelling, tenderness significantly. Refers to clubbing refers to the other no abnormal findings. Laboratory seizure: serum: uric acid 142.3μmol / L, urea nitrogen 2.5mmol / L, creatinine 88.4μmol / L: erythrocyte sedimentation rate 78mm / h; anti “O” rheumatoid factor negative. Is a “lumpy” increased shadow size of about 5 × 3cm. Extremity bone orthopedic examination: diffuse tubular periosteal symmetry periosteal hyperplasia,