超声下关节炎患者膝关节积液分布特点

目的通过超声检查了解关节炎患者膝关节积液分布情况。方法收取2012年7-12月于本院风湿科就诊的膝关节疼痛患者,应用高频超声探查患者髌上囊外侧区、中区及内侧区的积液情况,评估不同区域积液深度、长度及横截面积的差异。结果共纳入38例68个膝关节,膝关节外侧区及中区的积液深度分别为（4.8±4.5）mm及（4.5±4.3）mm,显著高于膝关节内侧区域的（3.1±4.3）mm（P〈0.001）;膝关节外侧区及正中区积液长度分别为（26.5±18.1）mm及（28.5±19.7）mm,显著高于膝关节内侧区的（18.7±20.5）mm（P〈0.001）,而外侧区及中区积液深度、长度间差异无统计学意义（P〉0.05）。根据积液量分组后,少量积液组髌上囊外侧区及中区积液显著高于内侧区（P〈0.001）,大量积液组中区与内侧区的差异无统计学意义（P=0.133）。类风湿关节炎（rheumatoid arthritis,RA）积液量（405.6±325.4）mm^2显著高于脊柱关节炎（spondyloarthritis,SpA）（213.5±241.6）mm^2（P=0.004）及骨关节炎（osteoarthritis,OA）（74.6±72.3）mm^2（P=0.005）。结论膝关节少量积液主要分布于外侧区及正中区,行膝关节穿刺等操作优先选择外侧区及正中区,有助于提高操作的成功率。

Distribution of ultrasound-detected knee joint effusion in arthritis patients

Objective To investigate the distribution of ultrasound（US）-detected knee joint effusion in arthritis patients.Methods Lateral,midline and medial regions of suprapatellar pouch effusion and its depth,length,cross section area in arthritis patients admitted to our department from July 2012 to December 2012 were detected by high resolution ultrasound examination.Results Thirty-eight arthritis patients with 68 knee joints involved were enrolled in this study.The maximal effusion depth and length were significantly higher in lateral and midline regions of knee joint than in medial region of knee joint（4.8±4.5） mm and（4.5±4.3）mm vs（3.1±4.3） mm,（P 0.001）;（26.5±18.1） mm and（28.5±19.7） mm vs（18.7±20.5） mm,（P 0.001）.No significant difference was observed in effusion depth and length between lateral and midline regions of knee joint（P 0.05）.The amount of effusion was significantly greater in lateral and midline regions of knee joint in those with a small amount of effusion（P 〈0.001）.No significant difference was found in the effusion in middle and medial regions of knee joint in those with a large amount of effusion（P=0.133）.The amount of effusion was significantly greater in those with rheumatoid arthritis than in those with spondyloarthritis or osteoarthritis（405.6±325.4） mm^2vs（213.5±241.6） mm^2vs（74.6±72.3） mm^2,（P=0.004,P=0.005）.Conclusion A small effusion is mainly distributed in the lateral and midline regions of knee joint.Lateral and midline regions of knee joint are the first choice of knee joint puncture,which contributes to its success.