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<title>整形外科医の関節リウマチ診療ABC | 株式会社文光堂</title>


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<meta name="description" content="リウマチの薬物治療が大きく進歩したことによって，リウマチ診療における外科的治療の適応と役割も変化している．本書は整形外科医が是非とも知っておかなくてはいけないリウマチの薬物治療について，まずわかりやすくまとめた．内科治療を十分理解した上で，整形外科医はいかなる外科的治療をすべきか，どのようにリハビリに回すかを解説した．リウマチはすべての整形外科医が日常診療で必ず遭遇する疾患であり，今日整形外科医に">

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		<h1 class="catchCopy">整形外科医に望まれるリウマチ治療のための必携書！</h1>
		

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		<h1 class="title">整形外科医の関節リウマチ診療ABC<span class="version"></span></h1>
		

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					責任編集：久保俊一（京都府立医科大学大学院教授）
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					編集：西田圭一郎（岡山大学大学院准教授）
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					<span class="transparent">編集</span>　小田　良（京都府立医科大学大学院講師）
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				<ul class="property"><li class="disc">B5判・236頁・2色刷</li><li class="disc">ISBN&nbsp;978-4-8306-2735-4</li><li class="disc">2016年4月9日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">リウマチの薬物治療が大きく進歩したことによって，リウマチ診療における外科的治療の適応と役割も変化している．本書は整形外科医が是非とも知っておかなくてはいけないリウマチの薬物治療について，まずわかりやすくまとめた．内科治療を十分理解した上で，整形外科医はいかなる外科的治療をすべきか，どのようにリハビリに回すかを解説した．リウマチはすべての整形外科医が日常診療で必ず遭遇する疾患であり，今日整形外科医に望まれる治療を行うために，本書は必須の書である．</section><section class="preface">巻頭言<br><br>　関節炎により疼痛と変形をきたす関節リウマチは，整形外科の日常診療で必ず遭遇する疾患です．20世紀のリウマチ外科は， 疾患コントロールが不良であるゆえに持続する強い滑膜炎と，次々と破壊される関節に対する外科的治療の連続でした．21世紀に入り，病態のより深い理解とともに，分子標的薬の進歩によって，リウマチ治療は大きく変化しています．現在では早期に診断し，効果的な薬物療法を積極的に行うことができれば，疼痛は改善し，関節破壊および身体機能障害を最小限に抑制することができるようになりました．生物学的製剤の導入後10年が経過し，繰り返す手術に疲れ果てる患者は減少し，残存する関節炎と関節破壊および変形に対する手術を，高いモチベーションのもとに希望する患者が増加してきています．<br>　新しい臨床専門医制度の施行を控えて，整形外科専門医にとってリウマチ診療の基本的知識は必須です．リウマチ専門医においては，整形外科系専門医であっても高度な診断と薬物療法の知識が求められます．診断においては分類基準を理解し，適正に使用することはもちろん，より適切な鑑別診断を補助するための画像診断も大切です．また，薬物療法においては，合併症の評価，リスク・ベネフィットを勘案した薬剤選択，薬効評価のための血清学的・画像的モニタリング，さらには副作用の早期発見・早期治療のための知識が求められます．さらに，疼痛と身体機能評価，外科的治療の適応とその実施，周術期の薬剤マネジメント，装具療法やリハビリテーションなど整形外科的専門知識の重要性も従来以上に高まってきています．<br>　本書はこれから整形外科専門医・リウマチ専門医を目指そうとする若い医師のための入門書であり，これらの基本的知識を簡潔にまとめています．視覚に訴える図表や写真が充実し，アップデートされた豊富な参考文献も記載されています． 執筆陣は，新進気鋭の医師が中心となっています．「One point lesson」や「私のヒヤリハット」は，初学者にとって臨床的に有用です．<br>　整形外科医が関節リウマチのトータルマネジメントに携わることは，先人達が培ってきた整形外科医療の一端を継承することでもあります．薬物療法の進歩とともに，関節リウマチの治療体系も大きく変化しています．整形外科医はその基本をしっかりと身につけてリウマチ治療を担うべきです．<br><br>2016年3月<br>久保　俊一（責任編集）<br>西田圭一郎（編集）<br>小田　　良（編集）</section><section class="indexes">第1章　知っておくべき診断と評価のエッセンス<br>　1． 病因・病態のup-to-date<br>　2． 診断・鑑別診断<br>　　1） 早期診断の重要性とwindow of opportunity<br>　　2） 新分類基準の意義とピットフォール，鑑別すべき疾患<br>　　（1） 内科医から見たRAの鑑別診断のチェックポイント<br>　　●ACPA陰性，CRP陰性，でもRA<br>　　（2） 整形外科医から見たRAの鑑別診断のチェックポイント<br>　　●忘れてはいけない足の診察<br>　　●パーンと全体に腫れた手や足を見たら<br>　　（3） 小児科医から見た慢性関節炎の鑑別のチェックポイント<br>　3． 診察方法<br>　　1） 患者への接し方・診療のコツ<br>　　2） 身につけたい部位別身体所見の取り方<br>　　（1） 上肢<br>　　（2） 下肢<br>　　　a． 股関節<br>　　　b． 膝<br>　　　c． 足部<br>　　（3） 脊椎<br>　4． 検査値の読み方・考え方<br>　　　一般血液・生化学・炎症マーカー・免疫血清学的検査・抗体検査<br>　5． 画像診断の見方とピットフォール<br>　　1） 単純X線（関節）<br>　　2） MRI<br>　　3） エコー<br>　　4） CT<br>　　5） PET<br>　　●RA診療における胸部X線，胸部CT読影のコツ<br>　6． 疾患活動性の評価（DAS，SDAI，CDAI，ACR，VAS）<br>　7． 治療方針決定までのプロセス<br>第2章　知っておくべき薬物治療のエッセンス<br>　1． チャートで見る薬物療法<br>　　1） 薬物療法の目標とは？ 限界は？<br>　　2） 薬効評価の方法<br>　　3） 開始前のチェックポイント<br>　　4） ステロイドとcsDMARDの上手な使い方とピットフォール<br>　　●分子標的型DMARD<br>　　5） 生物学的製剤選択の実際<br>　　6） 合併症のある患者に対する薬物療法<br>　　7） 周術期の薬物管理のエビデンス<br>　　●日常診療で差がつく！ 関節内注射・腱鞘内注射のコツ<br>　2． 骨粗鬆症管理の要点<br>　　骨粗鬆症の評価と薬物治療<br>　3． リウマチ患者の痛みの管理<br>　　1） RAの痛みの考え方と評価法<br>　　2） 痛みの治療薬と使い方のコツ<br>第3章　知っておくべき外科的治療・リハビリテーションのエッセンス<br>　1． 最新の外科的治療─身体部位別の手術適応と手術のバリエーション<br>　　1） 上肢の手術<br>　　（1） 肩関節・肘関節<br>　　（2） 手関節<br>　　（3） 手指<br>　　2） 下肢の手術<br>　　（1） 股関節<br>　　（2） 膝関節<br>　　（3） 足部<br>　　3） 脊椎の手術<br>　　●リウマチのチーム医療<br>　2． リハビリテーション<br>　　1） RAのリハビリテーションの考え方─注意点と禁忌─<br>　　2） RAに有効な装具療法<br>　　3） 日常診療で使用すべき評価法<br>索　引<br><br>私のヒヤリハット<br>　痛みの強い小児の診察<br>　頚椎の動的撮像は安全か？<br>　指が伸びなくなったら<br>　生物学的製剤導入時のスクリーニング<br>　無症状でも副作用が潜んでいることがある<br>　MTXの過量投与に要注意<br>　MTX使用中の発熱・体重減少<br>　生物学的製剤使用中の皮膚潰瘍<br>　本当に風邪？<br>　こわい骨髄抑制<br>　ビスホスホネート使用中の注意<br>　腰椎固定術後の発熱と殿部痛<br><br>●＝One point lesson</section></article>
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