案例316:渐进性的伪质性发育不良症
Amit Gupta1, Narendra Bagri1, Stuti Chandola1
1From the Department of Radiodiagnosis and Interventional Radiology (A.G., S.C., M.J.) and Department of Pediatrics (N.B.), All India Institute of Medical Sciences, New Delhi 110029, India.
Radiology
|August 29, 2023
概括
一个10岁的男孩手关节胀和身材矮小,最初被误诊为青少年异常性关节炎. 进一步调查显示,一种罕见的遗传疾病影响骨和关节发育.
科学领域:
- 儿科风湿病学 儿科风湿病学
- 骨发育不良症 骨发育不良症
- 遗传疾病 遗传性疾病
背景情况:
- 青少年异常性关节炎 (JIA) 是儿童慢性关节炎的常见原因之一.
- 错误诊断可能导致治疗延迟和不理想的结果.
- 罕见的遗传疾病可以模仿自身免疫性关节病的表现.
研究的目的:
- 介绍一个儿童的病例,该儿童手部关节持续胀,身材矮小.
- 要突出诊断在区分罕见的骨疾病与JIA的挑战.
- 在复杂的儿科病例中强调全面骨评估的重要性.
主要方法:
- 一个10岁男孩的临床表现,有3年的手关节胀史.
- 身体检查发现包括非温柔的胀,曲形和矮身.
- 实验室检查 (正常的炎症标志物,阴性类风湿因素) 和骨检查.
主要成果:
- 患者表现出甲手腕关节和关节关节的胀和曲形.
- 发现身材矮小 (在三分之一以下).
- 炎症标志物和类风湿因子是负的,与典型的JIA不一致.
结论:
- 临床图像和消极的炎症标志物表明了除了JIA之外的诊断.
- 骨检查对于进一步的诊断评估至关重要.
- 这一案例强调了需要考虑儿科患者具有异型关节症状的罕见遗传骨功能障碍的必要性.
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