著者

瀬戸嶋 政勝 小林 靖幸 田中 宏明 栗林 善昭 井上 尚美

出版者

西日本整形・災害外科学会

雑誌

整形外科と災害外科 (ISSN:00371033)

巻号頁・発行日

vol.37, no.1, pp.229-233, 1988-10-25 (Released:2010-02-25)

参考文献数

6

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Since ankylosing spondylitis (A. S.) tends to be milder and less progressive in women that in men, there are great difficulties in early diagnosing A. S. in female patients. We report a case of A. S. in a woman. A 22-year-old woman with a 6-year history of A. S. was admitted to our hospital in Mar., 1987. The initial sign was gait disturbance due to severe left hip joint pain. Laboratory findings included an almost normal complete blood count, blood chemistry and urinalysis. The ESR at that time was 51mm/h, CRP was 2 puls, rheumatoid factor was negative and HLA B-27 antigen was detected.The plain roentgenogram revealed a narrowing of the joint space and an ankylosing change in the bilateral hip and sacroiliac joints. Routine X-ray examination of the spine showed an almost normal view. An open biopsy of the hip joint showed histopathologically nonspecific chronic inflammatory findings. A Tc-99m scintigram on Feb. 9, 1982 showed an increased activity area in the bilateral hips and sternoclavicular joints, in the sacroiliac joints especially in the iliac sides, and in a part of the cervical spine. This activity began in the early stage of A. S. However, a plain roentgenogram of these joints at that time showed normal findings.If history, clinical and laboratory findings lead to a suspicion of A. S., and there is little significant change by roentgenographic studies, the whole body scintigraphy is useful for the early diagnosis of A. S. in female patients.