高分辨率超声诊断银屑病关节炎的临床研究

High resolution ultrasonographic diagnosis of psoriatic arthritis

目的探讨超声检查在银屑病关节炎（PsA）早期诊断中的应用价值。方法应用高分辨率超声对29例有手指受累的PsA患者的69个手指行双侧对比扫查，观察PsA患者手指的超声声像表现及血流特点，并与30例类风湿关节炎（RA）的70个手指及20名健康志愿者双侧相应手指检查结果对比。采用，检验进行数据分析。结果PsA组有临床表现的手指均有超声阳性表现。共检出关节腔积液42个（61％）；滑膜炎38个（55％）；骨侵蚀28个（41％）；腱鞘炎40个（58％）；软组织炎29个（42％）；附着点炎30个（43％）。RA组检出关节腔积液52个（74％）；滑膜炎48个（69%）；骨侵蚀33个（47％）；未检测出腱鞘炎、软组织炎及附着点炎。结论高分辨率超声是PsA早期诊断和观察手指病变简便易行及安全有效的检查方法。

Objective In order to confirm the value of high resolution frequency （HFUS） uhrasonography in the early diagnosis of psoriatic arthritis （PsA）. Methods Twenty-nine patients with psoriatic arthritis reporting sixty-nine finger pain and 30 patients with rheumatoid arthritis reporting seventy finger pain and 20 healthy volunteers underwent X-ray and US evaluation. The ultrasonographie characteristics and blood flows in the joints were checked with high resolution ultrasonography. Bilateral joints were compared each other in every patient. Comparisons between groups were tested byx2 test. Results Sonographic positive signs were found in all the involved joints in 29 PsA patients, joint effusion in 42 fingers （61%）. Synovial thickening was found in 38 fingers （55%）. Bone erosions were found in 28 fingers （41%）, tenosynovitis were found in 40 fingers （58%）, soft tissue inflammation was revealed in 29 fingers （42%）. Enthesitis were found in 30 fingers （43%）. In RA patients, joint effusion was found in 52 fingers （74%） and synovial thickening in 48 fingers （69%）. Bone erosions were found in 33 fingers （47%）. Tenosynovitis, soft tissue inflammation and enthesitis were not found in RA patients.Conclusion High resolution ultrasonography is an easy, safe and effective method for the early diagnosis of pathological changes of small joints in psoriatic arthritis.