摘要
Charcot’s关节神经性关节病也称为Charcot’s关节病,1868年Charcot首先描述。此类疾病为无痛觉所引起,又有无痛性关节病之称,是一种较为罕见的神经营养性骨关节病,缺少特征性病理改变,易被误诊为其它疾病。笔者经治1例Charcot’s关节病误诊病例,原单位诊断为非特异性炎症改变。观察该病例的临床表现、病理学特点和影像学表现,并复习相关文献,旨在提高对该疾病的认识，减少或避免误诊。
Objective To investigate the clinicopathologic features and main points of diagnosis and differential diagnosis of Charcot＇s joint. Methods A case of Charcot＇s joint was studied and the related literatures were reviewed. Its clinical manifestations and pathomorphological characteristics were analyzed. Results A 41-year-old male was admitted to the hospital due to loss of range of motion （ ROM ） of the left shoulder joint progressively and painlessly. The X-ray showed the humeral head was partially missing. The CT represent ed irregular soft tissue mass es in high density with an indistinct edge, and discontiguous left seapulabone. The MRI showed changes of syringomyelia was presented in the glenoid cavity of the left shoulder joint, humeral head, proximal humerus and spinal cord of thoracic segments. According to the histological findings, free bone detritus accumulationswere microscopicallyseen in the lesions and adjacent soft tissues at an early stage, andthe secondary changes due to the reactions of osteoclast- likemultinucleated giant cells and inflammatory cells and proliferation of fibrous tissues. The formation of pannusacted as an important basisfor distinguishing Charcot＇s joint and other kinds of arthritis. Conclusions Charcot＇s joint is a kind of neuropathic arthropathy which lacks distinctive histopathologic features. So it is necessary to combine clinical features, pathological manifestations with radiographic examination results in clarifying the diagnosis. Only based on typical clinical symptoms, clear imaging features and mixed pathological changes of injury and repair, can a definitediagnosis be made.
出处
《中国骨与关节杂志》
CAS
2015年第5期430-432,共3页
Chinese Journal of Bone and Joint
