彩色多普勒超声对痛风性关节炎和骨性关节炎的鉴别价值

目的:探讨彩色多普勒超声对痛风性关节炎（GA）和骨性关节炎（OA）的鉴别价值。 方法:选取2014年12月~2017年12月收治的GA患者50例作为GA组，同期选取OA患者50例作为OA组，两组均给予彩色多普勒超声检查双侧第一跖趾关节，分析两组超声表现。 结果:GA组和OA组关节积液、滑膜增厚、滑膜血流分级比较，差异无统计学意义（P>0.05）；GA组和OA组多点状高回声、双轨征、痛风石比较，差异有统计学意义（P<0.05）；GA组急性期患者滑膜血流分级明显高于慢性期，差异有统计学意义（P<0.05）。 结论:彩色多普勒超声检查第一跖趾关节可对GA和OA作出有效的鉴别，其中GA滑膜血流分级可为GA病情评估提供重要的参考依据，值得临床进一步推广。

Value of color Doppler ultrasound in differential diagnosis of gouty arthritis and osteoarthritis

Abstract: Objective To discuss the diagnostic value of color Doppler ultrasound in differentially diagnosing gouty arthritis (GA) and osteoarthritis (OA). Methods Fifty patients with GA and 50 patients with OA who were treated in First People’s Hospital of Foshan between December 2014 and December 2017 were selected. Color Doppler ultrasound was applied to exam the first metatarsophalangeal joints in both two groups, and the ultrasound manifestations were analyzed. Results The comparison of joint effusion, synovial thickening, and the classification of synovial blood flow in GA group and OA group didn’t show any statistical differences (P>0.05). However, statistical significance was found in multi-point hyperechoic, double-track sign, and gouty tophi between GA group and OA group (P<0.05). The level of synovial blood flow in patients with GA at acute stage was significantly higher than that in those with GA at chronic stage, with statistical significance (P<0.05). Conclusion Using color Doppler ultrasound to exam the first metatarsophalangeal joint can effectively distinguish GA and OA. Moreover, GA synovial blood flow classification can provide important references for GA assessment, worthy of further clinical promotion.