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近几年来,我们曾误诊5例以四肢骨关节肿痛为首发症状的肺癌患者,现报道如下。1 临床资料5例均为男性,年龄45~62岁,病程2~7个月。其首发症状均为四肢骨关节肿胀、疼痛。其中四肢对称性腕、膝、踝关节肿痛2例,双胫腓骨及腕、指、膝关节肿痛2例,双胫腓骨及膝、踝关节肿痛1例,伴杵状指1例。初诊时误诊为风湿性关节炎1例,类风湿性关节炎4例,给予阿斯匹林、钰复康、芬必得、消炎痛等药物抗风湿治疗,治疗1~2个月复诊。3例复诊1次,2例复诊2次。复诊时均诉疗效不佳,且1例出现咳嗽、咯血,膝关节及腕关节X线表现为胫腓骨或尺桡骨远端出现骨膜增生,提示肥大性骨关节病。胸部X线检查均发现一团块状阴影,大小分
In recent years, we have misdiagnosed 5 cases of lung cancer patients with bone and joint swelling and pain of the limbs as the first symptom. The reports are as follows. 1 The clinical data of 5 cases were all males, aged 45 to 62 years and duration of 2 to 7 months. The first symptoms are swelling and pain in the joints of the limbs. Symptomatic wrist, knee, and ankle joints were involved in 2 cases of swelling and pain, 2 cases of double metatarsal and wrist, finger and knee joint swelling, 1 case of bilateral metatarsal and knee, ankle swelling, and 1 case of clubbing. One patient was misdiagnosed as rheumatoid arthritis at the time of initial diagnosis, and 4 cases of rheumatoid arthritis were given aspirin, buprofloxacin, fenpyral, indomethacin, and other anti-rheumatism drugs for one to two months. Three patients were referred once and two patients were referred twice. All patients complained of poor efficacy at the time of referral, and one patient developed cough and hemoptysis. The X-rays of the knee joint and wrist joint showed periosteum hyperplasia at the distal end of the radius or ulna, suggesting hypertrophic osteoarthropathy. Chest X-ray examination found a mass of shadows, size points