前沿进展胸锁关节肥厚性骨炎的延迟诊断严
北京白癜风哪个医院最好 http://wapyyk.39.net/bj/zhuanke/89ac7.html
作者：vanderKlootWA
翻译：邓晓莉校正：张警丰刘湘源
发布：柴静审核：赵金霞
摘要：目的：胸锁关节肥厚性骨炎是一种少见的前胸壁慢性无菌性骨髓炎，病因不清，常常与特征性的掌跖脓疱病相关。该病在确诊前常常被延误多年。本研究目的是追溯这类患者的诊断轨迹，以研究诊断延误的后果。方法：回顾性收集分析52例经临床、核医学以及放射科确诊的胸锁关节肥厚性骨炎患者的资料。结果：大多数患者表现为胸锁关节部位的肿痛或者肩带肌附近的活动受限。约30%的患者合并掌跖脓疱病。诊断延误的时间为3.5年左右。在确诊前患者往往就诊于3个科室以上。对该病临床表现认识的缺乏以及诊断的延误与患者身体、精神以及社会经济上的不良后果密切相关，显著影响患者生活质量。结论：胸锁关节肥厚性骨炎尽管特点鲜明，仍然极易被误诊。对该病认识不足导致延误诊断会对患者生活的多个方面造成显著的不利影响。提高对该病的认识，使得患者能够及时得到诊断和治疗，有助于减轻患者因诊断延误而不能得到治疗带来的身体和精神痛苦。附原文：OBJECTIVE:Sternocostoclavicularhyperostosis(SCCH)isarare,debilitating,chronicinflammatorydisorderoftheanteriorchestwallduetoachronicsterileosteomyelitisofunknownorigin,oftenassociatedwithcharacteristicskinlesionsofpalmsandsoles:pustulosispalmoplantaris.SCCHgoesoftenunrecognizedforyearsbeforethediagnosisisestablishedandtreatmentinstituted.TheobjectiveofthisstudywastotracethediagnosticpathsofpatientswithSCCHandtoinvestigatetheconsequencesassociatedwithdiagnosticdelay.METHODS:Datawerecollectedthroughstructuredinterviewsof52patientswithaclinically,scintigraphically,andradiologicallyestablisheddiagnosisofSCCH.RESULTS:Themajorityofpatientspresentedwithswellingand/orpaininthesternocostoclavicularregionand/orlimitedmovementoftheshouldergirdle.Pustulosispalmoplantariswaspresentinapproximately30%ofpatients.Thediseasewentunrecognizedforamedianof3.5years.Patientswereoftenseenbyatleast3membersofthemedicalprofessionbeforethediagnosiswassuspectedandeventuallyestablished.Lackofrecognitionoftheclinicalmanifestationsofthediseaseanddelayindiagnosiswereassociatedwithimportantphysical,psychological,andsocioeconomicconsequencesaffectingqualityoflife.CONCLUSION:SCCHremainsanill-recognizeddiseasedespiteitscharacteristicclinicalfeatures.Alowlevelofawarenessofthedisorderleadstoadelayindiagnosis,whichhasasignificantimpactonvariousaspectsofqualityoflife.Awarenessshouldberaisedforthisdisorder,enablingtimelydiagnosisandinitiationoftreatmenttopreventtheirreversiblephysicalandpsychologicalsequelaeassociatedwiththeprotracteduntreatedstate.引自：vanderKlootWA,ChotkanSA,KapteinAA,HamdyNA.Diagnosticdelayinsternocostoclavicularhyperostosis:impactonvariousaspectsofqualityoflife.ArthritisCareRes(Hoboken).Feb;62(2):-7.
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