最后审阅: 8 四月 2021
最后更新: 22 六月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 关节发热、肿胀、疼痛、活动受限
  • 急性表现

其他诊断因素

  • 发热
  • 大关节
  • 单关节
  • 假体关节
  • 症状活动度
  • 性活动
  • 游走性红斑
  • 危险因素

危险因素

  • 潜在关节病
  • 假体关节
  • 年龄
  • 免疫抑制
  • 接触传播
  • 蜱虫暴露
  • 先前关节内皮质类固醇注射
  • 近期关节手术
  • 低等社会经济状况

诊断性检查

首要检查

  • 滑膜液显微镜检查、革兰染色和偏光显微镜检查
  • 滑膜液培养和药敏试验
  • 滑液白细胞计数
  • 血培养和药敏试验
  • 白细胞计数
  • 红细胞沉降率 (ESR)
  • C 反应蛋白 (CRP)
  • 尿素和电解质
  • 肝功能检查 (LFT)
  • X 线平片
  • 超声

需考虑的检查

  • 降钙素原 (PCT)
  • 磁共振成像 (MRI)
  • 滑膜液聚合酶链反应(PCR
  • 采集拭子进行显微镜检查、培养和药敏试验
  • 尿液试纸检测、显微镜检查、培养和药敏试验
  • 酶联免疫吸附试验 (ELISA)
  • 滑膜活检

治疗流程

撰稿人

Emergency Medicine Consultant

Royal London Hospital

Barts Health NHS Trust

Honorary senior lecturer

Queen Mary University

London

UK

利益声明

JG declares that he has no competing interests.

CT1 anaesthetics

Anaesthetic Department

Peterborough City Hospital

Peterborough

UK

利益声明

TY declares that he has no competing interests.

BMJ Best Practice would like to gratefully acknowledge the previous team of expert contributors, whose work is retained in parts of the content:

Gerald Coakley PhD, FRCP

Consultant Rheumatologist

Queen Elizabeth Hospital

London

UK

GC is an author of a reference cited in this topic.

Catherine J. Mathews MSc, FRCP

Consultant Rheumatologist

Queen Elizabeth Hospital

London

UK

CJM is an author of a reference cited in this topic.

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Consultant Rheumatologist

Lewisham and Greenwich NHS Trust

London

UK

利益声明

CJM is an author of references cited in this topic.

Section Editor, BMJ Best Practice

利益声明

CP declares that she has no competing interests.

Lead Section Editor, BMJ Best Practice

利益声明

RW declares that she has no competing interests.

Lead Section Editor, BMJ Best Practice

利益声明

TAO declares that she has no competing interests.

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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