痛风性关节炎超声检查病理基础及临床应用现状

痛风性关节炎(gouty arthritis)是因嘌呤高代谢或肾脏中尿酸钠(monosodium urate, MSU)排出减少,导致血清尿酸钠(serum uric acid, SUA)浓度升高,MSU晶体沉积于关节及其周围诱发的进展性炎性疾病,晚期可出现关节畸形及功能障碍,早期诊断和及时干预治疗能显著改善预后,提高患者生活质量。超声检查(ultrasound, US)能够发现痛风性关节炎关节部位的双轨征(double contour sign, DCS)、痛风结节(tophaceous)、痛风石(tophi)、暴风雪征(snowstorm sign)、高回声云雾区(hyperechoic cloudy areas, HCA)及痛风样骨质侵蚀等声像,在痛风的早期诊断及疗效监测中具有重要的临床价值。因而本文就痛风性关节炎的超声检查病理基础及其临床应用价值进行综述,并对其发展做出展望。

Ultrasound pathological basis and clinical application status of gouty arthritis

Gouty arthritis is caused by high purine metabolism or decreased excretion of sodium urate (MSU) from the kidneys, which leads to an increase in serum sodium uric acid (SUA) concentration, and MSU crystals are deposited on the joints and their surroundings induced progressive inflammatory diseases, joint deformities and dysfunction may appear in the late stage. Early diagnosis and timely intervention can significantly improve the prognosis and improve the quality of life of patients. Ultrasound can detect double contour sign (DCS), tophaceous, tophi, snowstorm sign, and hyperechoic cloud areas (HCA) in the joints of gouty arthritis which have important clinical value in the early diagnosis of gout and the monitoring of therapeutic effects. Therefore, this article reviews the ultrasound pathological basis of gouty arthritis and its clinical application value and makes a prospect for its development.