肩关节梅毒性关节炎—1例报告与综述

Syphilitic arthritis of the shoulder: a case report and review

摘要:

梅毒性关节炎是较为罕见的疾病，且其症状表现多样，极易发生漏诊误诊。本文报告 1 例 61 岁女性患者，发热、 右肩肿痛、活动受限 10 个月。行关节镜检查，见关节腔滑膜增生，部分呈结节样和胶冻样改变，肩袖断裂，肱骨头及关节盂破坏，部分缺损。刨削清理增生的滑膜组织，刮除清理肱骨头和肩盂碎裂的软骨及瘢痕。滑膜组织病理检查发现钩端螺旋体。 结合此病例，本文对梅毒性关节炎的临床影像特点、诊断和鉴别诊断以及治疗进行文献综述，为临床医师提供参考。

Abstract:

Syphilitic arthritis is a very rare disease with diverse symptoms, therefore, prone to be of miss diagnosis or misdiagnosis. In this paper, we report a 61-year-old female patient with fever, right shoulder swelling and pain, and mobility limitation for 10 months. Ar- throscopy revealed synovial hyperplasia with some nodular and jelly-like changes, rotator cuff rupture, destruction of the humeral head and glenoid complicated with partial defects. The hyperplastic synovial tissue was debrided by shavers, and the broken cartilage and scar of the humeral head and glenoid were removed. Histopathological examination of the synovium revealed leptospira. Combined with this case, this paper also mentioned the clinical and imaging features, diagnosis, differential diagnosis, and treatment of syphilitic arthritis by a literature review to provide reference for clinicians.