Tubercle and _'s general knowledge of differentiation of others disease

Tubercle and _'s general knowledge of differentiation of others disease
1.Acute gout arthritis
Tubercle patient 5%-25% can infringe the joint, among them is shown as acute arthritis partly. 25% of the patients can accompany hematuria and acid to increase, so apt to misdiagnose as gout. But this kind of arthritis present symmetry more, many joints are given much trouble. Given much trouble in the position and referred to with the knee, ankle near end (toe) The joint, wrist, elbow joint are the most common, single arthritis is extremely rare. But gout 90% more than get up disease for single joint, give much trouble position to be most common for first metatarsophalangeal articulation joint. And gout easy to take place on between twenty and fifty man, breeding time rare woman, more than man women, disease of tubercle. In addition, can find urine sour salt crystallization in the gout joint liquid of arthritis, can distinguish with tubercle.
2.Rheumatic fever
The two can display much joints, visit walking inflammation, with nodular erythema of the skin. But often there is pharyngitis medical history of streptococcus to teenagers and before the disease more commonly in rheumatic fever. Can find to check ASo raises, and how normal SACE is in the laboratory. In addition, rheumatic fever is apter to present heart inflammation to behave than tubercle, the situation that and the lung is given much trouble is obviously reduced.
3.Rheumatoid and arthritis
Damage, present as joint, tubercle of disease chronic to pass, involve hand, wrist,etc., need to distinguish with rheumatoid and arthritis at the little joint. But chronic joint, tubercle of disease change disease appear later period in tubercle more, so compatible lung and other behavior and serum ACE that organ is given much trouble rise at the same time often. In addition, it is non- aggressive that the joint of tubercle is damaged and presented more, and pathological change of RA is mainly in the joint, present aggressive joint, destroy, abarticular to give much trouble little light, besides RF, can find such as resist Sa, AKA, APF, resist RA33/36 other antibodies. Slippery membrane examine the intersection of tubercle and disease, it presents to be the intersection of cheese and kinds of swollen granulation while being living.
4.Bone Paget disease
Tubercle can display and dissolve the bone change, there can also be osteosclerosis, or both exist at the same time, similar bone Paget disease. But the bone of tubercle changes and often amalgamates chronic skin to change, serum ACE level rises, and AKP normal in level, bone live it examines to be the intersection of cheese and kinds of swollen granulation, can distinguish with Paget osteopathy.
5.Dry syndrome
Infringe lachrymal gland, parotid gland as the intersection of tubercle and disease, can lead to the fact mouth do, eyes do and gland body swelling, apt and dry syndrome is obscured. But there should be specific one's own antibodies in dry syndrome, for instance: Resist SS-A, resisting SS-B or RFANA,etc.. Pathology can be seen lymphocytes while checking present cooking stove infiltration, but not the swollen manifestation of a kind of granulation of cheese.
6.Multiple myositis
Myopathic type muscle tubercle takes reducing and amyotrophy of proximal muscular strength as the core, CK can rise. The electric picture of skin can also display the original damage of skin. Lives and examines and helps the two to distinguish for but therapeutic reaction difference to glucocorticoid, the skin.
7.Vascular inflammation
Can involve the big, medium and small blood vessel, is exactly like big arteritis when infringing the trunk. Live and can distinguish to examine.
8.Lung door scrofula
Patient's age is often under 20 years old, there can be tuberculosis and is poisoned symptom, the masculine gender of tuberculin test, finding the tuberculosis fungus can be made a definite diagnosis of the phlegm sometimes. The enlargement of lymph nodes of X-ray examination lung door, are mostly the single side, the lung can see and have illness coming on in the cooking stove originally. It is negative to test Kveim.
9.Lung cancer
Especially central lung cancer, often shift with the lung door lymph node, cause it with the enlargement of lymph nodes of the side lung door, but tumour all has a corresponding symptom to shift outside primary lung cancer or lung. Body layers of photography, lung CT, fibrous bronchus mirror live, examine and phlegm cytologic to check, contribute to differential diagnosis.
10.Lymphoma
In clinic, X-ray and immunology change and tubercle is rather similar. Common all over symptom is generating heat, weight lightening and anaemia,etc., enlargement of lymph nodes often inclines to merge (the lung door lymph node of tubercle is often held with the fate of right heart) with the reason of right heart on the lung door ,Often there is a lung door lymph node that oppresses symptom.
11.Lung mycosis
The X-ray examination of chest is similar to tubercle sometimes, it contributes to differential diagnosis that the phlegm looks for the mould and mould to train.
12.Other diseases
Congenital heart disease, pneumosilicosis, viral pneumonia, beryllium lung substantially as shunting right on the left,etc. can cause the enlargement of lymph nodes of one pair of sides lung door too, and Crohn' s ill, primary bile duct sclerosis is chronic granulation swollen pathological change, but should be easy to distinguish according to their own characteristics.
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