摘要: |
目的:分析类风湿关节炎(rheumatoid arthritis,RA)手腕部骨侵蚀(bone erosion,BE)声像图表现并评价肌骨超声在其检测中的应用价值。方法:76例确诊为类风湿关节炎的患者均行手腕部(包括腕关节、掌指关节和近端指间关节)肌骨超声检查。检查模式包括灰阶超声(grey-scale ultrasonography,GSUS)和能量多普勒超声(power Doppler ultrasonography,PDUS);检查项目包括滑膜炎、腱鞘炎和BE(按2010年EULAR OMERACT标准:从长轴和短轴两个相互垂直的两个切面均探及骨质缺损),记录BE部位与数量。对各关节病变超声表现进行半定量分级并计算总评分。以SPSS19.0软件统计BE与滑膜炎、腱鞘炎评分的相关性。结果:76例RA患者中超声检出49例(44.64%)、共86处BE病变。BE数量GSUS评分手腕部滑膜炎GSUS、PDUS评分均呈正相关(r = 0.579,P < 0.01;r = 0.765,P < 0.01)。BE的GSUS评分与手腕部滑膜炎GSUS、PDUS评分均呈正相关(r = 0.634,P < 0.01;r = 0.828,P < 0.01)。BE数量、GSUS评分与腱鞘炎GSUS评分、PDUS评分均无显著相关性(P > 0.05)。结论:肌骨超声能有效检测RA手腕部BE病变;而且BE的发展与关节滑膜炎特别是其活动性的发展程度密切相关。 |
关键词: 类风湿关节炎 骨侵蚀 超声 手腕 评分 |
DOI: |
投稿时间:2017-10-28修订日期:2017-10-30 |
基金项目: |
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Analysis of Ultrasonography of Bone Erosions in Hands and Wrists of Rheumatoid Arthritis |
Wu Changjie,Hua Xing |
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Abstract: |
Objective To analyze the ultrasonography of bone erosions (BE) in hands and wrists of the patients with rheumatoid arthritis (RA) and to evaluate the value of musculoskeletal ultrasound in the detection of BE. Methods Musculoskeletal ultrasonography of hands and wrists (including wrist, metacarpophalangeal and proximal interphalangeal joints) was performed in 76 patients with RA. Gray-scale ultrasonography, (GSUS) and power Doppler ultrasonography (PDUS) were used to detect synovitis, tenosynovitis and BE (according to the standards of 2010 EULAR OMERACT: defect of bone cortex is detected in both perpendicular sections of the longitudinal and short axes of lesion). The locations and amounts of BE were recorded. Ultrasonography of each joint lesion was semi-quantitatively graded and total scores were calculated. The relationships between BE and scores of synovitis and tenosynovitis were analyzed by SPSS 19.0. Results EB was detected in 49 cases among 76 patients with RA, with a total of 86 lesions. The number of BE was positively correlated with synovitis scores of both GSUS and PDUS (r = 0.579, P < 0.01; r = 0.765, P < 0.01). The GSUS score of BE was also positively correlated with synovitis scores of both GSUS and PDUS (r = 0.634, P < 0.01; r = 0.828, P < 0.01). There was no significant correlation between BE parameters and tenosynovitis scores (P > 0.05). Conclusion Musculoskeletal ultrasonography can effectively detect BE lesions of hands and wrists in patients with RA. The development of BE is closely related to the severity of joint synovitis, especially the activity of inflammation. |
Key words: rheumatoid arthritis bone erosion ultrasonography hands and wrists scoring |