目的 探讨以关节炎为首发表现的儿童结核病的诊治.方法 回顾分析5例关节结核病患儿的临床资料.结果 患儿均为男性,年龄(8.5±2.9)岁;均以关节症状就诊,病程长短不一,最长者3年,4例外院诊断为类风湿性关节炎并治疗;2例有结核接触史,2例有骨质破坏,1例伴有病理性骨折.结论 关节结核病易误诊为幼年特发性关节炎,须注意鉴别诊断.%Objective To explore the diagnosis and treatment of five children with tuberculosis with arthritis as the initial manifestation. Methods The clinical features, laboratory tests and imaging manifestation of 5 children with joint tuberculosis were retrospectively analyzed. Results The course of disease was different. All the five patients were males (mean age 8.5 ±2.9 years old) and suffered from articular symptoms as initial feature. Four of them were diagnosed and treated as rheumatoid arthritis by other hospitals for up to three years, two patients have tuberculosis contact history, and another two patients were found with bone destruction, and one patient has pathologic fracture. Conclusions Tuberculosis is easily misdiagnosed as juvenile idiopathic arthritis , which deserves attention from a pediatric rheumatology physician.
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