患者男,52岁。突发左足拇趾关节红肿疼痛3天就诊。患者于3天前突发左足拇趾跖趾关节处红肿疼痛,局部皮温高,不能负重。辅助检查白细胞5.7×10~9/L,淋巴细胞0.40,中性细胞0.54,尿常规未见异常,抗链球菌溶血素“O”阳性,血沉18mm/小时,X 光片示左足拇趾第一趾节远端有一小圆形骨密度减低影,周围光滑整齐,骨密度增高。初步诊断为风湿性关 Male patient, 52 years old. Sudden left foot big toe joint swelling and pain for 3 days treatment. Patients with sudden left toe metatarsophalangeal joint swelling and pain at 3 days ago, local skin temperature is high, can not bear weight. Auxiliary examination of white blood cells 5.7 × 10 ~ 9 / L, lymphocytes 0.40, 0.54 neutral cells, urine no abnormalities, anti-streptolysin “O ” positive, erythrocyte sedimentation rate 18mm / The distal end of the first toe had a small circular bone density to reduce the shadow around the smooth and tidy, increased bone density. Initial diagnosis of rheumatic off