Weekly Case

Title : Case 29

첨부파일 : 윤영철_선생님_증례.ppt

Age / Sex : 29 / F


Age/Sex: 29/F

C.C.: multiple joint pain





1) What is your impression?

Courtesy : Young Cheol Yoon, MD., Samsung Medical Center, Sungkyunkwan University School of Medicine


Diagnosis:

MCTD (mixed connective tissue disease)



Discussion


Radiologic findings
- Acroosteolysis of right 1st, right 2nd, and left 2nd finger tip
- Marginal erosion of left 2nd PIP
- Joint space narrowing of bilateral radiocarpal joints
- Periarticular calcium deposition of bilateral 2nd MCP, 3rd PIP, and 3rd DIP joints
MR findings
- Abnormal high signal intensity areas with enhancement and patch distribution in bilateral vastus muscles

Diagnosis : Mixed connective tissue disease (MCTD)

Differential diagnosis :
- Rheumatoid arthritis, Scleroderma Discussion

- MCTD is characterized by overlapping clinical features of scleroderma, SLE, dermatomyositis, and RA 
 - Both adults and children can be affected. 
 - Involvement of the small joints of the hand and foot, as well as the wrist, is typical. 
- The most important laboratory finding is the presence of ribonucleoprotein antibodies in serum



Correct Answer
Name Institution
성미숙 (감별진단 정답) : 가톨릭대 성가병원
김완태 (감별진단 정답) : 서울 보훈병원
오배근 (감별진단 정답) : 일산 백병원 전공의
박소영 (감별진단 정답) : 경희 의료원 전공의
박상현 (감별진단 정답) : 순천향대학 천안병원 전공의

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