近端指间关节周围胶原沉积症影像学的诊断价值

Imaging features of para-proxymal interphalangeal collagen deposition and their diagnosis value

目的 探讨近端指间关节周围胶原沉积症的影像学表现及在其诊断中的价值.方法 回顾性分析于河北联合大学附属开滦总医院临床证实的11例近端指间关节周围胶原沉积症患者的临床表现及影像学表现.结果 11例行普通X线检查,11例双侧第3指、8例双侧第2及第4指、5例双侧第5指近节指间关节软组织影呈梭形增厚;均未见骨质改变.6例患者多螺旋CT检查,显示第3、4指近节指间关节周围关节囊影增厚,骨性关节面结构完整.5例行MRI检查显示双侧第2、3、4指近节指间关节关节囊软组织影增厚,边缘光滑,未见炎性渗出信号影,关节软骨规则,信号均匀,关节腔未见积液影,皮下脂肪层清晰.结论 近端指间关节周围胶原沉积症特征影像学表现为近端指间关节周围软组织增厚,其内未见炎性渗出病变影,关节面骨质、关节软骨及滑膜无受累,影像学检查对于诊断和鉴别诊断有重要价值.

Objective To discuss image features of para-proximal interphalangeal collagen deposition.Methods The clinical manifestation and imaging features were retrospectively analyzed in 11 patients with paraproximal interphalangeal collagen deposition.Results All 11 patients underwent plain X-ray examination.11 patients had bilateral third,8 patients had bilateral second and forth and 5 patients had bilateral fifth of proximal interphalangeal fusiform soft tissue swollen.6 patients who underwent MSCT showed that the third and fourth proximal interphalangeal joint capsules were swollen.5 patients who underwent MRI showed that bilateral second,third and fourth proximal interphalangeal joint capsules were swollen without inflammatory exudation and the surface of cartilage was smooth and complete ; no fluid was seen in articular cavity.Conclusions The image feature of paraproximal interphalangeal collagen deposition is proximal interphalangeal soft tissue thickening without inflammatory exudation.Articular surface,cartilage and synovial membrane are not involved.