痛风性关节炎的高频超声表现

目的 探讨痛风性关节炎的超声表现特征。方法 分析22例临床确诊的痛风性关节炎且曾有急性痛风发作的32个受累关节的超声表现。 结果 受累关节共32个:第一跖趾关节28个(28/32,87.50%),膝关节2个(2/32,6.25%),踝关节1个(1/32,3.13%),肘关节1个(1/32,3.13%)。所有受累关节均有超声阳性表现。超声表现:关节积液30个(30/32,93.75%),滑膜增生16个(16/32,50.00%),骨侵蚀10个(10/32,31.25%),关节软骨"双边征"25个(25/32,78.13%),关节液内"暴雪样"回声10个(10/32,31.25%),关节内点状强回声8个(8/32,25.00%),关节内片状强回声团伴声影15个(15/32,46.88%),关节旁肌腱周围强回声8个(8/32,25.00%),关节周围滑囊积液4个(4/32,12.50%)。 结论 痛风性关节炎在高频超声下有多种表现,且部分超声表现具有特异性。高频超声可作为诊断痛风性关节炎的重要影像学方法。

High-frequency ultrasonographic findings of gouty arthritis

Objective To explore the ultrasonographic features of gouty arthritis. Methods Sonographic manifestations of 32 joints with acute gout attack in 22 gouty arthritis patients were analyzed. Results Thirty-two involved joints included 28 first metatarsophalangeal joints (28/32, 87.50%), 2 knee joints (2/32, 6.25%), 1 ankle joint (1/32, 3.13%) and 1 elbow joint (1/32, 3.13%). Sonographic positive performance were found in all the involved joints, including effusion in 30 joints (30/32, 93.75%), synovial hypertrophy in 16 joints (16/32, 50.00%), bony erosion in 10 joints (10/32, 31.25%), double contour sign of articular cartilage in 25 joints (25/32, 78.13%), snowstorm appearance of the joint fluid in 10 joints (10/32, 31.25%), hyperechoic spots in 8 joints (8/32, 25.00%), intraarticular patchy hyperechogenicity with posterior acoustic shadow in 15 joints (15/32, 46.88%), hyperechogenicity around the periarticular tendon in 8 joints (8/32, 25.00%) and effusion in periarticular synovial bursa in 4 joints (4/32, 12.50%). Conclusion Gouty arthritis has multiple high-frequency ultrasonographic representations, some of them are specific.High-frequency ultrasound can be used as an important imaging technique for detection of gouty arthritis.