高频超声在诊断类风湿关节炎患者指关节病变中的应用

Application of high frequency ultrasonography in diagnosing the finger joint lesions in patients with rheumatoid arthritis

目的:探讨高频超声在类风湿关节炎患者指关节病变的中的诊断价值。方法:选取2017年1月-2018年1月于我院收治的42例RA患者及40例健康志愿者,用高频超声观察两组的双手近端指间关节和掌指关节,测量滑膜的厚度,并检测肌腱、关节腔、骨质病变情况。结果:78.57%(33/42)的患者存在滑膜增生,约42.86%(18/42)的患者存在肌腱病变,有8例患者的腱鞘内出现少量积液;有6例患者的关节腔内出现积液;有6例患者可见骨质破坏,表现为连续性中断;有4例患者出现关节融合,无法寻找到关节腔。关节病变程度与病程相关,滑膜增生多见于发病时间少于5年的患者,骨质破坏、关节融合多见于病程大于10年的患者。结论:高频超声在RA患者手指关节病变的诊断中具有很高的医学应用价值,其费用低廉、操作简便、可重复性好,还可用于随访观察疗效,值得在临床上推广应用。

Objective:To explore the value of diagnosing the finger joint lesions in patients with rheumatoid arthritis by high frequency ultrasonography.Methods:42 patients with RA and 40 healthy volunteers admitted to our hospital from January 2017 to January 2018 were enrolled.The proximal interphalangeal joints and metacarpophalangeal joints in both groups were observed by high frequency ultrasonography.The thickness of the synovium was measured.The tendon,joint cavity and bone lesions were detected.Results:Synovial hyperplasia was detected in 78.57%(33/42)of patients.Tendon lesions were detected in approximately 42.86%(18/42)of patients.8 patients were occurred a small amount of hydrops in the tendon sheath.6 patients were occurred hydrops in articular cavity.6 patients were occurred destruction of bone.4 patients were occurred arthrodesis and could not find the articular cavity.Conclusion:High frequency ultrasonography shows high medical value in the diagnosis of finger joint lesions in RA patients,is inexpensive,easy to operate,can also be used for follow-up observation and is worthy of clinical application.