第一跖趾关节超声在诊断痛风中的作用

The value of ultrasound examination of the first metatarsophalangeal joint in diagnosis of gout

探讨第一跖趾关节超声检查对于诊断痛风的价值。收集2011年12月至2012年7月门诊或住院的痛风急性发作患者35例，超声检查患者双侧第一跖趾关节、膝关节及踝关节。痛风发作时，超声检查第一跖趾关节可发现关节腔积液、滑膜增厚、关节腔强回声点、关节滑膜强回声点、痛风石及“双边征”等特征；在所有检查的关节中，第一跖趾关节出现超声异常的频率显著高于膝关节与踝关节（P＜0.01）；并且第一跖趾关节较膝关节和踝关节更易出现“强发光点”、“痛风石”及“双边征”3种痛风特异性超声影像特点（P＜0.01）。第一跖趾关节超声检查有助于快速诊断痛风。

To explore the value of ultrasound examination of the first metatarsophalangeal joint in the diagnosis of gout. From December 2011 to July 2012, 35 outpatients or in-hospital patients with acute gouty arthritis were collected. Ultrasonography of bilateral first metatarsophalangeal joints, knee joints, and ankle joints were performed. The ultrasound examination of the first metatarophalangeal joint of patients with gout, revealed joint effusion, synovial hypertrophy, hyperechoic spots in synovial fluid or on synovium surface, tophus, and ＂double contour sign＂. The finding of abnormal ultrasonic image in the first metatarsophalangeal joint was significantly higher than that in knee joint and ankle joint（P〈0.01）. And the first metatarsophalangeal joint is prone to show ＂hyperechoic spots＂, tophus, and ＂double contour sign＂, which are ultrasound imaging characteristics specific to gout（P〈0.01）. Ultrasound examination of the first metatarsophalangeal joint helps diagnose gout more efficiently.