Monoartritlerin değerlendirilmesi, bir yıllık, retrospektif tek merkez deneyimi

Yıl 2021, Cilt: 54 Sayı: 3, 399 - 404, 01.01.2022

Müçteba Enes Yayla

https://doi.org/10.20492/aeahtd.974893

Öz

Amaç: Mevcut çalışmada 3. Basamak bir sağlık kuruluşuna monoartrit kliniği ile başvurmuş hastaların genel özelliklerini, değerlendirmeler sonucu almış oldukları tanıları, hangi hastaların kronikleştiğini ve oligoartrit ya da poliartrit kliniğine ilerlemiş olduğunu ortaya koymayı amaçladık.
Gereç ve Yöntem: Ekim 2019 – Ekim 2020 tarihleri arasında 18 yaşından büyük ve bilinen romatolojik bir hastalığı olmayan ilk kez monoartrit kliniğine sahip olmuş 92 hasta retrospektif olarak incelendi. Tüm hastaların özellikleri, değerlendirmeler sonucu almış oldukları tanıları kaydedildi. Kronik artritli hastalar ile kendini sınırlayan artritli olan hastaların özellikleri karşılaştırıldı.
Bulgular: Hastaların %66,3’ ü erkekti. En fazla etkilenen eklemler diz (%38), 1.metatarsofalangeal (MTF) eklem (%31,5) ve ayak bileği eklemleriydi (%20,7). Hastaların %60,9’ unda klinik, tedavi ile ya da spontan olarak kendini sınırlamıştı, %39,1 hastada kronik artrit ortaya çıktı. Kronik artrit gelişen hastaların 7’ sinde monoartrit tablosu oligoartrit ya da poliartrit tablosuna dönmüştü. Hastaların klinik değerlendirme süreci sonunda almış olduğu tanılara bakıldığında gut %37, periferik SPA %15,2, RA %9,8 ve Behçet %4,3 hastada saptandı. Diğer tanılar ise septik artrit, post-streptokoksik artrit, undiferansiye bağ dokusu hastalığı, sjögren hastalığı, malignite ilişkili artrit, travmaya sekonder artrit ve osteoartritti. %19 Hastada ise sınıflandırılamayan artrit tablosu tespit edildi Erkek cinsiyet (p=0.028) ve hiperürisemi (p<0.001) kendini sınırlayan artritlerde daha sıkken, RF (p=0.005) ve CCP (p=0.006) pozitifliği, progresif artrit sıklığı kronikleşen artritlerde daha sıktı.
Sonuç: 3. Basamak bir sağlık kuruluşuna çeşitli monoartrit nedenleri ile hastalar sıklıkla başvurabilmektedir. Hastaların doğru tanı ve tedaviyi zamanında alması olası morbiditeyi önlemek açısından önemlidir.

Anahtar Kelimeler

monoartrit, gut, kendini sınırlayan artrit, kronik artrit

Destekleyen Kurum

Yok

Evaluation of monoarthritis, one-year, retrospective single-center experience

Öz

Aim: In the current study, we aimed to reveal the general characteristics of the patients who applied to a tertiary health institution with a monoarthritis clinic, the diagnoses they received as a result of the evaluations, which patients became chronic, and progressed to the clinic of oligoarthritis or polyarthritis.
Material and Method: Between October 2019 and October 2020, 92 patients who were older than 18 years of age and had no known rheumatologic disease and had a monoarthritis clinic for the first time were analyzed retrospectively. The characteristics of all patients and the diagnoses they received as a result of the evaluations were recorded. The features of patients with chronic arthritis and patients with self-limiting arthritis were compared.
Results: 66.3% of the patients were male. The most affected joints were knee (38%), first metatarsophalangeal (MTF) joint (31.5%) and ankle (20.7%). In 60.9% of the patients, the clinic was self-limited with treatment or spontaneously, and chronic arthritis developed in 39.1% of the patients. In 7 of the patients who developed chronic arthritis, the monoarthritis table turned into oligoarthritis or polyarthritis. Considering the diagnoses of the patients at the end of the clinical evaluation process, gout was found in 37%, peripheral SPA in 15.2%, RA in 9.8% and Behçet's syndrome in 4.3%. Other diagnoses were septic arthritis, post-streptococcal arthritis, undifferentiated connective tissue disease, Sjogren's disease, malignancy-associated arthritis, arthritis secondary to trauma, and osteoarthritis. Unclassifiable arthritis was detected in 19% of the patients. While male gender (p=0.028) and hyperuricemia (p<0.001) were more common in self-limiting arthritis, RF (p=0.005) and CCP (p=0.006) positivity and progressive arthritis were more common in chronic arthritis.
Conclusion: Patients could frequently apply to a tertiary health institution with various causes of monoarthritis. It is important for the patients to receive the correct diagnosis and treatment in a timely manner in order to prevent possible morbidity.

Kaynakça

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