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目的探讨以外周关节受累为首发症的强直性脊柱炎临床特点并对误诊原因进行分析。方法回顾性分析2003年1月～2005年12月诊治的26例以外周关节受累为首发症的强直性脊柱炎的临床特点,分析误诊原因。结果26例患者中有17例曾在外院及本院门诊被误诊,误诊率为65．4%,误诊疾病有化脓性关节炎、风湿性关节炎等。结论以外周关节受累为首发症的强直性脊柱炎早期症状不典型,容易误诊误治,应加强对其临床特点的认识,对疑似强直性脊柱炎患者应常规行双侧骶髂关节CT检查及血HLA-B27检查。
Objective To investigate the clinical features of ankylosing spondylitis with peripheral involvement as the first symptom and analyze the causes of misdiagnosis. Methods The clinical features of 26 cases of ankylosing spondylitis with peripheral joint involvement as the initial symptom from January 2003 to December 2005 were analyzed retrospectively. The causes of misdiagnosis were analyzed. Results Of the 26 patients, 17 cases were misdiagnosed in outpatient and outpatient clinics. The misdiagnosis rate was 65.4%. The misdiagnosed diseases were septic arthritis, rheumatoid arthritis and so on. Conclusions Early symptoms of ankylosing spondylitis with peripheral joint involvement as the first symptom are not typical, so it is easy to misdiagnosis and mistreatment. Knowledge of clinical features should be strengthened. Patients with suspected ankylosing spondylitis should routinely undergo bilateral sacroiliac joint CT examination and Blood HLA-B27 examination.