高频超声在诊断类风湿关节炎患者指关节病变中的应用

High frequency ultrasound in the diagnosis of finger joints damage in rheumatoid arthritis patients

目的探讨高频超声在诊断类风湿关节炎(RA)患者手指关节病变中的价值。方法RA患者42例,健康志愿者40名,分别应用高频超声观察双手掌指关节和近端指间关节,测量滑膜厚度,检测有无肌腱、关节腔和骨质病变。结果RA患者79%(33/42)存在滑膜增生,18例患者可见肌腱病变,5例病人可见关节腔积液,5例患者可见骨质破坏,3例患者可见关节融合。病程少于5年的病例主要表现为滑膜增生,而骨质破坏、关节融合的病例病程多在10年以上。结论高频超声可应用于RA患者手指关节病变的诊断。

Objective To investigate the value of high frequency ultrasonography in the diagnosis of finger joints damage in rheumatoid arthritis （RA） patients. Method Metacarpophalangeal （MCP） and proximal interphalangeal （PIP） joints of 42 RA patients and 40 healthy volunteers were examined by high frequency ultrasonography. The thickness of the synovial membrane were measured. The tendon, width of joint space, bone were observed. Results Synovial membranes of most fingers （16/20） of RA patients were thicker signifi cantly than those of healthy volunteers. Synovitis of finger joints were found in 79% （33/42） RA patients. Tendon abnormalities were detected in 42.9% （18/42） patients. Intra-articular fluid were found in 5 patients. Five patients showed bone destruction. Articular space width were disappeared in 3 patients. Synovitis were the main abnormalities in patients whose disease duration was less then 5 years. Bone destruction and articuler space width disappearance were mainly found in patients whose duration of disease was more then 10 years. Conclusion High frequency ultrasonography can be used in examining the finger joint damage in RA patient.