【原】201.Scleroderma （ 硬皮病）

每天朗读一段医学影像学英语文章

History

▶ Hand pain in two different patients

病史：两位不同患者手部疼痛。

Findings

In the first patient (Fig. 26.3), marked erosion and resorption of the distal phalangeal tufts are noted with associated resorption of the soft tissues of the fingertips worse at the fifth digit (small white arrows). In the second patient (Fig. 26.4), amorphous calcifcation in the soft tissues of the second through fifth fngertips with mild distal sof tissue resorption is noted (white arrows). Note also the erosive destruction of the second distal phalanx (arrowhead).

影像表现：
第一位患者，远节指骨基底部明显骨质破坏和骨质吸收，同时要注意还有指尖的软组织吸收，尤以第五手指为甚。
第二位患者，从第二到第五手指指尖软组织模糊钙化，伴远端软组织轻度吸收。同时注意第二指骨远端的骨质破坏。

Teaching Points

▶ Scleroderma, or progressing systemic sclerosis, is a chronic disease that affects the skin, heart, lungs, gastrointestinal tract, kidneys, and musculoskeletal system.

▶ 46% of patients with this disease have arthropathy, which is limited to the hands and wrists.

▶ Resorption of the soft tissues of the fingertip with or without amorphous calcifcations is the frst visible radiographic change.

▶ Radiographic changes include:

1. Resorption of the soft tissues of the fingertip

2. Subcutaneous calcifcations

3. Erosions of the distal tufts (which may progress to resorb entire tuft)

4. Acrosclerosis

▶ Occasional erosive disease of the IP joint or first CMC joints may be seen.

要点：
-硬皮病，或进行性系统性硬化，是一种慢性疾病，可累及皮肤、心脏、肺、胃肠道、肾脏和肌骨系统。
-46的患者伴有关节病，导致手部和腕部活动受限。
-指尖软组织吸收，伴/不伴模糊钙化影，是影像检查的首要表现。
-影像表现包括：指尖软组织吸收、皮下钙化、远节指骨基底部骨质破坏（可进行性破坏整个指骨底）、肢端硬化症。
-骨质破坏偶尔也会累及指间关节和第一掌指关节。

Notes：

1. Scleroderma [ˌsklɪrə'dɜ:mə] n. 硬皮病

2. erosion [ɪˈrəʊʒ(ə)n] n. 侵犯

3. phalangeal  [feɪ'lændʒɪrl] n.指骨的，趾骨的

4. amorphous [əˈmɔ:rfəs] adj. 模糊的

5. phalanx [ˈfeˌlæŋks, ˈfælˌæŋks] n. 方阵; 趾骨，指骨

6. sclerosis [skləˈroʊsɪs] n. 硬化症

7. gastrointestinal [ˌgæstroʊɪnˈtestɪnl] adj. 胃肠的

来源：每天朗读一段医学影像学英语文章

圈主

深圳市人民医院放射科副主任医师杨敏洁

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