下腿切断がＡＤＬの改善に有用であった足部慢性骨髄炎を合併した悪性関節リウマチの一例

概要

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A 49-year-old man with equinus foot (left side) was diagnosed with malignant rheumatoid arthritis (MRA) . Uncontrollable disease activity led to plantar forefoot ulceration of the left fifth metatarsal bone with osteomyelitis. The activity of MRA was brought under control after steroid pulse therapy and etanercept administration. However, the patient suffered from bilateral hip joint pain because of severe joint damage and faced difficulty in standing and walking. In order to control the infection, below-knee amputation was performed. After the patient was fitted with a prosthesis, bilateral total hip arthroplasties were performed. The patient is now able to walk for short distances and is satisfied with the treatment. A below-knee amputation of the lower limb is effective in MRA patients with chronic osteomyelitis of the foot who require total arthroplasty of any joint of the lower extremity.
日本関節病学会の論文