A Case of Rheumatoid Arthritis Improved from Steinbrocker Classification Class IV to Class II after Multi-Joint Surgery
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概要
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We report the case of a patient with rheumatoid arthritis (RA) who showed a reduction in disease severity (from class IV to class II) after multi-joint surgery. The patient was a 61-year-old man with a history of RA, type-2 diabetes, chronic obstructive pulmonary disease, and nephrotic syndrome. He had been undergoing treatment for RA for the past 10 years, but his condition could not be appropriately controlled. In addition to generalized edema, marked destruction of the left elbow joint and knees was observed, and he was unable to move in bed (Steinbrocker classification: stage IV, class IV).<BR>In March 2009, he developed suppurative arthritis of the left elbow (methicillin-sensitive <I>Staphylococcus aureus</I> [MSSA] infection) and was referred to our institution, where the infection subsided after cleaning of the wound and administration of antibiotics. In March 2010, he underwent artificial joint replacement arthroplasty of the left elbow, followed by replacement arthroplasty of the right knee in July that year and of the left knee in November. As of December 2011, the patient showed no signs of inflammatory reactions and was able to walk using crutches (Steinbrocker classification: stage IV, class II). Recent advancements in pharmacotherapy have made it possible to control the advancement of joint destruction in RA. However, in this patient, because of the advanced stage of joint destruction, surgical methods were required to aid the patient in recovering his ability to walk.
著者
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Nagata Kensei
Department Of Orthopedic Surgery Kurume University School Of Medicine
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Yano Mayumi
Department Of Physics Faculty Of Science Ochanomizu University
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Fukuda Takaaki
Department Of Internal Medicine Kurume University Medical Center
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Kume Shinichiro
Department Of Pathology Kurume University School Of Medicine
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Nagata Kensei
Department Of Orthopaedic Surgery Kurume University
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Okawa Takahiro
Department Of Applied Chemistry Keio University
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HONDA SEIYO
Department of Rheumatic Collagen Desease, Kurume University Medical Center
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Honda Seiyo
Department of Internal Medicine, Kurume University School of Medicine
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HIGUCHI FUJIO
Department of Orthopaedic Surgery, Kurume University Medical Center
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GOTOH MASAFUMI
Department of Orthopaedic Surgery, Kurume University Medical Center
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FUKUDA TAKAAKI
Department of Rheumatic Collagen Desease, Kurume University Medical Center
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MATSUDA KOTARO
Department of Orthopedic Surgery, Kurume University Medical Center
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MITSUI YASUHIRO
Department of Orthopedic Surgery, Kurume University Medical Center
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YOSHIKAWA EIICHIRO
Department of Orthopedic Surgery, Kurume University Medical Center
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NAGATA KENSEI
Department of Orthopaedic Surgery ,Kurume University School of Medicine
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MITSUI YASUHIRO
Department of Orthopaedic Surgery, Kurume University Medical Center
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KUME SHINICHIRO
Department of Orthopedic Surgery, Kurume University Medical Center
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