摘要
目的:探讨肌肉骨骼超声在跖趾类风湿关节炎与痛风性关节炎骨侵蚀中的鉴别诊断意义。方法:选择痛风性关节炎患者246例(痛风组)与类风湿关节炎105例(风湿组)作为研究对象,所有患者都给予肌肉骨骼超声检查,记录超声特征并判断诊断价值。结果:痛风组的痛风石、双边征、高回声点等占比都高于风湿组(均P<0.05)。两组跖趾积液深度、骨面侵蚀深度与肿胀厚度对比差异无统计学意义(均P>0.05)。痛风组滑膜血流半定量评分高于风湿组(P<0.05)。肌肉骨骼超声对跖趾类风湿关节炎与痛风性关节炎骨侵蚀的鉴别诊断敏感性为98.5%,特异性为99.0%。结论:肌肉骨骼超声能根据骨侵蚀分布特点与滑膜血流状况,有效鉴别诊断跖趾类风湿关节炎与痛风性关节炎患者,有很好的临床应用价值。
Objective:To investigate the significance of musculoskeletal ultrasound in the differential diagnosis of metatarsophalangeal rheumatoid and gouty arthritis bone erosion.Methods:246 cases of patients with gouty arthritis(gout group)and 105 cases of patients with rheumatoid arthritis(rheumatism group)were selected as research objects.All cases were given musculoskeletal ultrasound examination,the ultrasound characteristics were recorded and the diagnostic value was judged.Results:The proportions of tophi,bilateral signs,and hyperechoic points in the gout group were higher than those in the rheumatism group(all P<0.05).There was no significant difference in the depth of metatarsophalangeal effusion,the depth of bone erosion and the thickness of swelling between the two groups(all P>0.05).The semi-quantitative score of synovial blood flow in the gout group were higher than that in the rheumatism group(P<0.05).The sensitivity of musculoskeletal ultrasound in the differential diagnosis of metatarsophalangeal rheumatoid and gouty arthritis bone erosion was 98.5%,and the specificity was 99.0%.Conclusion:Musculoskeletal ultrasound can effectively differentiate and diagnose metatarsophalangeal rheumatoid and gouty arthritis patients accord to the characteristics of bone erosion distribution and synovial blood flow.It has good clinical application value.
作者
封小川
李利霞
FENG Xiaochuan;LI Lixia(Department of Ultrasound Diagnosis,Yan’an People’s Hospital,Yan’an 716000,China)
出处
《陕西医学杂志》
CAS
2021年第7期833-835,共3页
Shaanxi Medical Journal
基金
陕西省延安市科技计划项目(SL2019ZCSY-001)。
关键词
肌肉骨骼超声
第一跖趾关节
类风湿性关节炎
痛风性关节炎
骨侵蚀
Musculoskeletal ultrasound
First metatarsophalangeal joint
Rheumatoid arthritis
Gouty arthritis
Bone erosion
