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患者,男,73岁。四肢远端关节疼痛30年,关节畸形,皮下结节5年,反复在当地住院按“类风湿性关节炎”治疗。体查:T 37℃,Bp 20/12kPa。慢性病容,体质消瘦,胸略呈桶状,双肺呼吸音正常,心率80次/分,律齐,无杂音。肝脾未及,四肢指(趾)关节及腕关节、踝关节均明显畸形,活动受限,诸关节附近可见数十个大小不等之皮下结节,大者如鸟蛋大小,小者如蚕豆大小,较大之皮下结节有波动感。化验:血、尿常规正常,ESR 80mm/h,ASO小于500u,PSP2小时排泄
Patient, male, 73 years old. Extremities distal joint pain for 30 years, joint deformity, subcutaneous nodules 5 years, repeatedly in the local hospital according to “rheumatoid arthritis” treatment. Physical examination: T 37 ℃, Bp 20 / 12kPa. Chronic disease, physical weight loss, chest slightly barrel, lungs normal breathing, heart rate 80 beats / min, law Qi, no noise. Lack of liver and spleen, limbs and fingers (toe) and wrist joints, ankle were significantly deformed, limited mobility, the joints can be seen in dozens of different sizes of subcutaneous nodules, such as the size of the egg, the smaller such as Broad bean size, larger subcutaneous nodules have a sense of volatility. Laboratory: blood, urine normal, ESR 80mm / h, ASO less than 500u, PSP2 hours excretion