A Medical Mystery — Arthritis
http://www.100md.com
《新英格兰医药杂志》
A 51-year-old woman with a 15-year history of rheumatoid arthritis presented with swelling and loss of function of the right shoulder. Magnetic resonance imaging of the shoulder revealed severe destruction of the humeral head with an elevated signal of the bone marrow (Panel A). Puncture revealed 60 ml of a white colloidal fluid (Panel B). The results of polarizing microscopy are shown in Panel C. What is the diagnosis?
Editor's note: We invite our readers to submit their answers at www.nejm.org/mystery. We will publish the diagnosis in the Correspondence section of the July 27, 2006, issue and e-mail it to everyone who submits an answer. All answers must be received by June 14, 2006.
Tim L. Jansen, M.D., Ph.D.
Anneke Spoorenberg, M.D., Ph.D.
Medisch Centrum Leeuwarden
8934 AD Leeuwarden, the Netherlands
Editor's note: We invite our readers to submit their answers at www.nejm.org/mystery. We will publish the diagnosis in the Correspondence section of the July 27, 2006, issue and e-mail it to everyone who submits an answer. All answers must be received by June 14, 2006.
Tim L. Jansen, M.D., Ph.D.
Anneke Spoorenberg, M.D., Ph.D.
Medisch Centrum Leeuwarden
8934 AD Leeuwarden, the Netherlands