| 崔兰兰,徐华军.肌骨超声在早期类风湿性关节炎的临床应用[J].浙江中西医结合杂志,2021,31(12): |
| 肌骨超声在早期类风湿性关节炎的临床应用 |
| The clinical application of musculoskeletal ultrasound in early rheumatoid arthritis |
| 投稿时间：2020-09-16 修订日期：2021-10-19 |
| DOI： |
| 中文关键词: 早期类风湿性关节炎 非典型关节炎 肌骨超声 磁共振 滑膜炎 |
| 英文关键词:Early rheumatoid arthritis Undifferentiated arthritis Musculoskeletal ultrasound MRI Synovial inflammation |
| 基金项目:湖州市公益性应用研究项目(2017GYB25) |
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| 中文摘要: |
| 目的 探讨肌骨超声在早期类风湿性关节炎中的临床应用价值。 方法 以2010美国/欧洲抗风湿病协会早期RA分类方法为标准,回顾性分析202例非典型关节炎临床及超声资料,比较早期RA组与非RA组超声及临床特征差异,同时对确诊RA者行磁共振检查,比较早期RA超声与磁共振在关节内炎症与关节结构破坏诊断差异。 结果 超声检查早期RA滑膜增生、滑膜炎、腱鞘炎及骨侵蚀明显高于非RA患者(P＜0.05)；早期RA组患者中超声和磁共振诊断滑膜炎与腱鞘炎阳性率两组差别不大(P＞0.05),而骨侵蚀和骨髓水肿阳性率磁共振明显高于超声(P＜0.05)。 结论 早期RA肌骨超声以滑膜增生、滑膜炎、腱鞘炎等关节内炎症为主,常伴骨侵蚀,肌骨超声在滑膜炎、腱鞘炎等关节内炎症评估中具有较高的可靠性,可与磁共振相媲美,是早期RA诊断与鉴别诊断首选的影像学检查方法。 |
| 英文摘要: |
| Objective To explore the application value of musculoskeletal ultrasound in early rheumatoid arthritis. Methods According to Rheumatoid arthritis (RA) criteria of 2010 American College of Rheumatology/European League Against Rheumatism(2010 ACR/EULAR),the clinical and ultrasound features of 202 patients with undifferentiated arthritis were retrospectively analyzed. The clinical and musculoskeletal ultrasound features of early RA were compared with those of non-RA. Magnetic resonance imaging were taken for those who were fulfilled the 2010 ACR/EULAR RA criteria,the joint inflammation and damage characteristics of musculoskeletal ultrasound and MRI were compared in patients with early RA. Results The ultrasonic features of synovial proliferation,synovial inflammation,tenosynovitis and bone erosion in patients with early RA were higher than those of non-RA(P＜0.05).There were no statistical difference in the findings of synovial inflammation and tenosynovitis by ultrasound and MRI in the patients with early RA(P＞0.05),while the presences of bone erosion and bone marrow edema by MRI were higher than musculoskeletal ultrasound(P＜0.05). Conclusion The patients with early RA will be more likely with synovial proliferation,synovial inflammation,tenosynovitis and bone erosion in the musculoskeletal ultrasound. The musculoskeletal ultrasound findings of synovial inflammation and tenosynovitis were similar with MRI,thus becoming the first imaging choice for patients with early RA. |
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