超声在类风湿性关节炎腕关节和指关节病变中的诊断价值

目的探讨超声对类风湿性关节炎(RA)患者腕关节、掌指关节、指间关节病变的诊断价值。方法 RA组患者32例,共704个关节,25例体检健康者为对照组,共550个关节,超声检测腕关节、掌指关节、近端指间关节的滑膜厚度、关节积液及增生滑膜血流信号。结果 RA组腕关节、掌指关节、指间关节的滑膜厚度较对照组增厚(P0.05)。RA组中,不同程度滑膜增厚占79.7%,关节积液占71.9%,肌腱腱鞘炎占39.5%,滑膜血流信号增多占34.5%,均较对照组增多,差异均有统计学意义(P0.05)。结论超声能够早期评估RA患者滑膜增厚状况、有无关节积液、肌腱和腱鞘炎症状况、增生滑膜血流状况,有望成为RA诊断的首选影像学检查方法。

Diagnosis value of high-frequency ultrasonography in wrist-finger joint lesions of rheumatoid arthritis

Objective To explore diagnosis value of ultrasonography in the wrist, metacarpophalangeal and interphalangeal joint lesions of rheumatoid arthritis （RA） patients. Methods Thirty-two patients with RA （704 joints） and 25 healthy volunteers （550 joints） were enrolled. Synovial thickness, joint effusion, tendon tenosynovitis and hyperplasia synovium blood flow in wrist joint, metacarpophalangeal and proximal interphalangeal joint were detected using high-frequency ultrasonography. Results Synovial thickness in wrist joint, metacarpophalangeal and interphalangeal joint was thicker in RA group than control group （P〈0.05）. In RA group, different degree of synovial thickening was 79.7%, joint effusion was 71.9%, tendon tenosynovitis was 39.5% and synovial vascular excessive hyperplasia was 34.5%. All parameters were higher in RA group than control group （P〈0.05）. Conclusion High-frequency ultrasonography can early evaluate the status of synovial thickening, joint effusion, tendon tenosynovitis, hyperplasia synovium blood flow in patients with RA, which is expected to become the preferred imaging examination method for the diagnosis of RA.