A 64-year-old woman with no prior medical history has had increasing back pain and right hip pain for the past decade. The pain is worse at the end of the day. On physical examination, she has bony enlargement of the distal interphalangeal joints (see image). Which of the following diseases is most likely the cause of this patient’s symptoms?
1例64岁女性患者,无既往病史,在过去十年中背痛和右髋关节疼痛加重。一天结束时疼痛加重。在体格检查中,她有远端指间关节骨性肿大(见图)。以下哪种疾病最有可能是该患者症状的原因?
(A) Gout
(B) Osteoarthritis
(C) Osteomyelitis
(D) Pseudogout
(E) Rheumatoid arthritis
答案解析:
骨关节炎是一种磨损和撕裂导致关节软骨破坏、软骨下骨形成、骨赘、硬化和其他退行性变化的疾病。它是常见的和进行性的,并随着年龄的增长而变得更加严重。通常在负重关节中表现为使用后疼痛,休息后改善。通常也累及远端指间关节。伴随影像表现包括关节间隙狭窄、硬化和存在骨赘。图像显示 Heberden 淋巴结,代表远端指间 (DIP) 关节骨性扩大。
正确答案:B
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