超声诊断银屑病关节炎

Ultrasonographic diagnosis of psoriatic arthritis

目的探讨超声对银屑病关节炎(PsA)的诊断价值。方法收集我院门诊及住院PsA患者32例,所有患者均接受超声及体格检查,包括双侧手足小关节、指甲及下肢主要附着点(股四头肌腱、髌韧带、跟腱及跖筋膜附着端)等,分别观察并计数上述关节、附着点及指甲受累情况,并进行统计学分析。结果体格检查发现406个(406/1792,22.66%)关节病变,79个(79/320,24.69%)附着点炎,84个(84/320,26.25%)指甲病变;超声检查发现492个(492/1792,27.46%)关节病变,166个(166/320,51.88%)附着点炎,203个(203/320,63.44%)指甲病变;超声检查阳性率均高于体格检查(P均<0.001)。结论超声能早于体格检查发现PsA患者关节、附着点及指甲病变,超声对PsA的诊断具有重要价值。

Objective To explore the value of ultrasound in diagnosis of psoriatic arthritis（PsA）.Methods Thirty-two patients with PsA were performed physical examination and musculoskeletal ultrasound.The hand and foot small joints,nails,and lower limbs entheses（quadriceps,patellar,achilleon tendons and plantar fascia）of all patients were examined.Abnormality of these joints,entheses and nails were detected and counted through ultrasound and physical examination,and the findings were compared statistically.Results Abnormalities in 406（406/1792,22.66%）joints,79（79/320,24.69%）entheses and 84（84/320,26.25%）nails were detected by physical examination,while abnormalities in 492（492/1792,27.46%）joints,166（166/320,51.88%）entheses and 203（203/320,63.44%）nails were respectively detected by ultrasound.The detection rates of ultrasound were higher than those of physical examination in joints,entheses and nails abnormalities respectively（all P〈0.001）.Conclusion US is earlier in demonstrating PsA involvement of small joints,entheses and nails than physical examination,and has an important value in diagnosis of PsA.