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目的分析幼年类风湿性关节炎的临床表现和X线诊断标准。方法回顾分析25例幼年类风湿性关节炎的临床、实验室表现和软组织、关节及骨质改变的X线特征进行分析。结果本组多关节19例,少关节6例。25例中18例同时出现膝、腕、踝关节肿胀,在腕关节的病例中13例合并2、3掌指关节及指间关节肿胀;12例显示髋关节肿胀;8例显示多个腕骨受侵蚀、缺损及关节间隙变窄;3例见一侧上桡骨小头边缘性小缺损;1例双侧锁骨关节面侵蚀缺损;2例见骨膜反应;6例膝关节呈气球样增宽,7个关节显示方髌,2个髌骨呈锥形;6例髋臼表面欠规则,变平;6例10个骶髂关节面欠规则;1例颈椎、1例髋关节、1例骶髂关节半脱位。2例骶髂关节作CT扫描,显示双侧骶髂关节面不规则缺损,间隙增宽。2例髋关节CT扫描显示一侧关节囊新月形低密度积液征及肿胀。结论临床上多关节疼痛,肿胀、低热、四肢出现皮疹、晨僵及实验室检查结果多项异常。X线平片显示多关节肿胀及关节骨质破坏,关节间隙变窄,关节半脱位,CT扫描显示关节积液是本病的重要诊断根据。
Objective To analyze the clinical manifestations and diagnostic criteria of juvenile rheumatoid arthritis. Methods Retrospective analysis of 25 cases of juvenile rheumatoid arthritis clinical, laboratory performance and soft tissue, joint and bone changes X-ray characteristics were analyzed. Results The group of 19 cases of multi-joint, less joint in 6 cases. Twenty-five of the 25 patients developed swelling of the knees, wrists and ankles at the same time. In the wrist cases, 13 cases were complicated with swelling of the metacarpophalangeal joints and interphalangeal joints. 12 cases showed swelling of the hip joint. Eight cases showed multiple carpal bones Erosion, defect and joint space narrowing; 3 cases, see the small radial margin on one side of the small defects; 1 case of bilateral bilateral clavicular surface erosion defect; 2 cases of periosteal reaction; 6 cases were widened balloon-like, 7 The joints showed square patella, two patellaes conical; 6 cases of acetabular surface due to rules, flatten; 6 cases of 10 sacroiliac joint face less rules; 1 case of cervical spine, 1 case of hip, 1 case of sacroiliac joint half Dislocation. 2 cases of sacroiliac joint for CT scan, showing bilateral bilateral iliac articular defect, gap widened. 2 cases of hip CT scan showed one side of the joint capsule crescent low density fluid signs and swelling. Conclusions Clinical joint pain, swelling, fever, rash appeared on the limbs, morning stiffness and laboratory tests results of a number of abnormalities. X-ray showed multi-joint swelling and joint destruction of bone, joint space narrowing, subluxation, CT scan showed joint effusion is an important diagnostic basis for the disease.