高频超声特征性表现在痛风性关节炎病变早期诊断价值
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摘要
目的探讨高频超声特征性表现在痛风性关节炎病变早期诊断中的价值。方法选取自2017年1月至2018年11月北部战区总医院收治的32例痛风性关节炎患者为B组,另选取同期在我院就诊的临床确诊为类风湿性关节炎或骨性关节炎的28例患者作为A组。两组患者均进行超声检查,记录并比较患者的全部受累关节的关节腔积液、滑膜增生、骨侵蚀及关节周围的尿酸盐沉积、双轨征、痛风石的检出率。结果两组患者关节腔积液、滑膜增生及骨侵蚀的检出率比较,差异无统计学意义(P>0.05)。B组双轨征、尿酸盐沉积、痛风石的检出率均高于A组,组间比较,差异均有统计学意义(P<0.05)。结论双轨征、尿酸盐沉积、痛风石为痛风性关节炎超声特征性表现,高频超声检查对痛风性关节炎具有较高诊断价值。
Objective To investigate the diagnostic value of characteristic performance of high-frequency ultrasound in early diagnosis of gout arthritis.Methods A retrospective study was performed on 32 cases of patients with gout arthritis(Group B)and 28 cases of patients with rheumatoid arthritis or osteoarthritis(Group A)who were admitted from January 2017 to November 2018.Ultrasound examination was performed in both groups,and the detection rates of joint cavity effusion,synovial hyperplasia,bone erosion,urate deposition around the joints,dual-track sign and tophus in all the affected joints were recorded and compared.Results There was no significant difference in the detection rates of articular effusion,synovial hyperplasia and bone erosion between the two groups(P>0.05).The detection rates of dual-track sign,urate crystals and tophus in Group B were all higher than those in Group A(P<0.05).Conclusion Dual-track sign,deposition of sodium urate deposition and tophus were ultrasonic characteristics of gout arthritis.High-frequency ultrasound has better diagnostic value in gout arthritis.
Objective To investigate the diagnostic value of characteristic performance of high-frequency ultrasound in early diagnosis of gout arthritis.Methods A retrospective study was performed on 32 cases of patients with gout arthritis(Group B)and 28 cases of patients with rheumatoid arthritis or osteoarthritis(Group A)who were admitted from January 2017 to November 2018.Ultrasound examination was performed in both groups,and the detection rates of joint cavity effusion,synovial hyperplasia,bone erosion,urate deposition around the joints,dual-track sign and tophus in all the affected joints were recorded and compared.Results There was no significant difference in the detection rates of articular effusion,synovial hyperplasia and bone erosion between the two groups(P>0.05).The detection rates of dual-track sign,urate crystals and tophus in Group B were all higher than those in Group A(P<0.05).Conclusion Dual-track sign,deposition of sodium urate deposition and tophus were ultrasonic characteristics of gout arthritis.High-frequency ultrasound has better diagnostic value in gout arthritis.
引文
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[13] De Avila Fernandes E,Bergamaschi SB,Rodrigues TC,et al.Relevant aspects of imaging in the diagnosis and management of gout[J].Rev Bras Reumatol Engl Ed,2017,57(1):64-72.
[2] Saag KG,Choi H.Epidemiology,risk factors,and lifestyle modifications for gout[J].Arthritis Res Ther,2006,8 Suppl 1:S2.
[3] Lai KL,Chiu YM.Role of ultrasonography in diagnosing gouty arthritis[J].J Med Ultrasound,2011,19(1):1-13.
[4] Dalbeth N,Clark B,Gregory K,et al.Mechanisms of bone erosion in gout:a quantitative analysis using plain radiography and computed tomography[J].Ann Rheum Dis,2009,68(8):1290-1295.
[5] Thiele RG,Schlesinger N.Ultrasonography shows disappearance of monosodium urate crystal deposition on hyaline cartilage after sustained normouricemia is achieved[J].Rheumatol Int,2010,30(4):495-503.
[6] Filippucci E,Delle Sedie A,Riente L,et al.Ultrasound imaging for the rheumatologist.XLVII.Ultrasound of the shoulder in patients with gout and calcium pyrophosphate deposition disease[J].Clin Exp Rheumatol,2013,31(5):659-664.
[7] Ogdie A,Taylor WJ,Weatherall M,et al.Imaging modalities for the classification of gout:systematic literature review and meta-analysis[J].Ann Rheum Dis,2015,74(10):1868-1874.
[8] McQueen FM,Doyle A,Dalbeth N.Imaging in gout--what can we learn from MRI,CT,DECT and US[J].Arthritis Res Ther,2011,13(6):246.
[9] 王楚彬,林腾,郑宝群,等.痛风性关节炎的肌肉骨骼超声表现及超声对其诊断意义[J].临床医学工程,2014,21(7):823-824.
[10] 曹君妍,任杰,黄冬梅,等.痛风性关节炎的超声表现[J].中华超声影像学杂志,2011,20(12):1051-1054.
[11] Pei J,Li N,Gao Y,et al.The J wave and fragmented QRS complexes in inferior leads associated with sudden cardiac death in patients with chronic heart failure[J].Europace,2012,14(8):1180-1187.
[12] Thiele RG,Schlesinger N.Ultrasonography shows disappearance of monosodium urate crystal deposition on hyaline cartilage after sustained normouricemia is achieved[J].Rheumatol Int,2010,30(4):495-503.
[13] De Avila Fernandes E,Bergamaschi SB,Rodrigues TC,et al.Relevant aspects of imaging in the diagnosis and management of gout[J].Rev Bras Reumatol Engl Ed,2017,57(1):64-72.