痛风性关节炎的肌肉骨骼超声表现及超声对其诊断意义

Musculoskeletal Ultrasonographic Manifestations and Diagnostic Significance for Gouty Arthritis

目的探讨肌肉骨骼超声对痛风性关节炎(GA)的诊断意义和痛风性关节炎的特殊表现。方法选择在我院就诊的41例痛风性关节炎患者以及选取41例表现相同的如类风湿性关节炎、骨关节炎等其他疾病患者,采用肌肉骨骼超声对所有患者的滑膜增生、软组织肿胀、腱鞘炎、骨侵蚀、滑囊骨化及痛风石等表现进行检查,并对其骨膜上血流情况和炎症程度进行评估。结果实验组痛风石、平行线、滑膜上及韧带内高回声点的发生率明显多于对照组,差异具有统计学意义(P<0.05);而腱鞘炎、骨侵蚀的发生更易出现于非GA患者中,且两组差异有统计学意义(P<0.05);出现痛风石、平行线、高回声点、韧带内高回声点一个或以上表现诊断GA的特异性是91.8%,敏感性是64.1%,ROCAUC值为0.737。结论肌肉骨骼超声影像显示关节内出现痛风石、平行线、滑膜上及韧带内高回声点对痛风性关节炎(GA)具有诊断价值。

Objective To explore musculoskeletal ultrasonographic manifestations and diagnostic significance for gouty arthritis （GA）. Methods We assigned 41 GA patients and 41 patients with rheumatoid arthritis, osteoarthritis and other diseases of which the manifestations were the same as GA to have musculoskeletal ultrasonography on synovial hyperplasia, soft tissue swelling, tenosynovitis, bone erosion, bursa ossification, gouty tophus and other symptoms. The periosteum blood flow and the degree of inflammation were evaluated. Results The incidence of hyperechoic points on gouty tophus, parallel lines, synovium and ligament in the experimental group were significantly higher than those of the control group （P 〈0.05）. And the incidence of tenosynovitis and bone erosion was significantly higher in the non-GA patients （P 〈0.05）. The diagnostic specificity of one or more hyperechoic points on gouty tophus, parallel lines, synovium and ligament for GA was 91.8%, with a sensitivity of 64.1% and a ROCAUC value of 0.737. Conclusions Musculoskeletal ultrasonography shows hyperechoic points on gouty tophus, parallel lines, synovium and ligament, which is valuable for diagnosing GA.