超声对跖趾类风湿与痛风性关节炎骨侵蚀的鉴别诊断及临床意义

Differential diagnosis and clinical significance of ultrasound on bone erosion of metatarsophalangeal rheumatoid arthritis and gouty arthritis

目的探讨超声对跖趾类风湿与痛风性关节炎骨质侵蚀的鉴别诊断及临床意义。方法选取我院2016年2月~2018年3月收治的126例关节炎患者,其中类风湿关节炎患者63例,痛风性关节炎患者63例,将126例患者随机分为研究组和对照组,每组各63例,研究组患者采用超声鉴别诊断,对照组患者采用X线诊断,对比两组与病理诊断的符合率;两组患者图像特征、疼痛评分差异。结果研究组对跖趾类风湿与痛风性关节炎检出率均高于对照组(P<0.05);研究组中误诊率低于对照组(P<0.05);超声对骨质侵蚀发生的部位、形态、痛风石、边界以及关节腔积液内点状高回声明显优于X线(P<0.05)。结论超声对跖趾类风湿和痛风性跖趾关节炎骨质侵蚀的诊断优于X线,可对跖趾类风湿关节炎和痛风性跖趾关节炎骨质侵蚀治疗起到指导作用。

Objective To explore the differential diagnosis and clinical significance of ultrasound in metatarsophalangeal rheumatoid arthritis and gouty arthritis. Methods From February 2016 to March 2018, 126 patients with arthritis were selected, including 63 rheumatoid arthritis patients and 63 gouty arthritis patients. 126 patients were randomly divided into study group and control group, 63 in each group. The patients in the study group were diagnosed by ultrasound and the patients in the control group were diagnosed by X-ray. The coincidence rate between the two groups and pathological diagnosis was analyzed, and the differences of image characteristics and pain scores between the two groups were compared. Results The detection rates of rheumatoid arthritis and gouty arthritis in the study group were higher than those in the control group(P<0.05). The misdiagnosis rate in the study group was lower than that in the control group(P<0.05). Ultrasound was superior to X-ray(P<0.05) in the location, shape, gouty stone, boundary of bone erosion and the point hyperecho in the effusion of joint cavity. Conclusion Ultrasound is superior to X-ray in the diagnosis of metatarsophalangeal rheumatoid arthritis and gouty metatarsophalangeal arthritis. It can guide the treatment of metatarsophalangeal rheumatoid arthritis and gouty metatarsophalangeal arthritis.