ABSTRACT
Objective:
To understand the characteristics and
diagnosis and
treatment of
brucellosis with
joint pain as the first clinical manifestation, and summarize the clinical
classification of
brucellosis complicated with
joint pain, so as to provide reference for
clinical diagnosis and
treatment.
Methods:
Cases of
brucellosis with first symptom of
joint pain diagnosed in the 940th
Hospital of PLA
Joint Logistic Support Force from January 2015 to January 2020 were selected. The main clinical features,
laboratory examination,
diagnosis and
treatment were analyzed.
Results:
A total of 82
patients with
joint pain of the first symptom were selected, including 61
males and 21
females.
Joint pain was the main complaint of the
patients, 63.4% (52/82) of the
patients visited
spine surgery department, 17.1% (14/82) visited minimally invasive
orthopedics department, 12.2% (10/82) visited rheumatic
immunology department, and 7.3% (6/82) visited
traditional Chinese medicine department.
Brucellosis patients with cervical lesions accounted for 22.0% (18/82), combined with lumbar lesions accounted for 51.2% (42/82). The
patients with elevated
C-reactive protein accounted for 68.3% (56/82), abnormal
liver function accounted for 52.4% (43/82), anti "O" positive accounted for 3.7% (3/82), abnormal
autoantibodies accounted for 6.1% (5/82), and
human leukocyte antigen-B27 (
HLA-B27) positive accounted for 12.2% (10/82). Four
patients with
HLA-B27 positive had sacroiliac
arthritis. All
patients were cured after standard and full
course therapy.
Conclusion:
Joint pain may be the first symptom of
brucellosis, and the lumbar
spine and
cervical spine are the most vulnerable parts.