摘要
目的比较超声与临床检查在发现脊柱关节炎(spondyloarthritis,SpA)患者附着点病变方面的差异。方法收集SpA患者,分别对其耻骨联合、双侧胸锁关节及下肢附着点(股四头肌腱、髌腱起点、髌腱止点、跟腱、跖底筋膜)进行临床检查及超声检查。根据临床检查结果将附着点分为临床附着点病变组及无临床附着点病变组。结果共纳入36例SpA患者,466个附着点中超声发现156处(33.48%)附着点病变,与临床检查45处(9.66%)存在统计学差异(P=0.000),其中髌腱止点(75%)、耻骨联合(64.71%)及跟腱(51.34%)最常受累。临床附着点病变组与无临床附着点病变组相比,超声显示肌腱厚度(P=0.007)和骨侵蚀(P=0.000)存在统计学差异。在下肢附着点中,滑囊炎(64%)为最常见的病变。结论同临床检查相比,超声可发现更多的附着点病变。除跟腱止点外,超声显示髌腱止点、耻骨联合、胸锁关节受累并不少见。
Objective To compare the ultrasonography（US） and clinical examination in detection of peripheral enthesopathy in patients with spondyloarthritis（SpA）.Methods Enthesis at symphysis pubis,bilateral sternoclavicular joint,and lower extremities（quadriceps tendon,proximal patellar ligament,distal patellar ligament,Achilles tendon and plantar aponeurosis） were detected in SpA patients by clinical and ultrasonographic examination.The patients were divided into clinical entheseal involvement group and none clinical entheseal involvement group according to the findings in clinical examination.Results Thirty-six SpA patients were enrolled in this study.Of the 466 attaching point lesions,156（33.48%） were detected by US and 45（9.66%） were detected by clinical examination（P=0.000）.Of the detected attaching point lesions,those at the distal patellar ligament,symphysis pubis,and Achilles tendon accounted for 75%,64.71%,and 51.34%,respectively.US showed that the tendon was thicker and the bone erosion was severer in clinical entheseal involvement than in none entheseal involvement group（P0.05）.Of the enthesis in lower extremities,bursitis was the most common lesion,accounting for 64%.Conclusion US can detect more enthesopathy at distal patellar ligament,sternoclavicular joint and symphysis pubis,except for distal Achille tendon than clinical examination.
出处
《解放军医学院学报》
CAS
2013年第2期137-139,共3页
Academic Journal of Chinese PLA Medical School
