慢性痛风性关节炎患者跟腱病变的超声学特征的探讨

The characteristics of the Achilles tendon in tophaceous gout:a study of ultrasound

目的:应用高频超声技术探讨痛风患者跟腱病变情况的分布及频率特征。方法:选取36例痛风患者作为痛风组,以及同性别、同年龄组的36名健康者作为对照组。所有患者均通过二维灰阶及能量彩色多普勒超声检查。对以下超声特征进行评估:痛风石、跟腱内强回声、跟腱内血流、跟腱及滑囊形态学。结果:痛风组大多数患者为中年男性(33/36,92%)。痛风组74%跟腱内存在痛风石(53/72),而对照组无(P<0.01)。与对照组相比,痛风组出现强回声点(P<0.01)和跟腱内能量多普勒信号(P<0.01)更频繁。跟腱结构损伤几乎为0。跟腱近段出现强回声点较中远段更普遍(P<0.01)。结论:痛风患者存在尿酸盐沉积、痛风石及血流信号的超声特征。除了尿酸盐沉积,其他跟腱内结构改变不常见。

Objective:To investigate the distribution and frequency characteristics of the Achilles tendon(AT)in patients with tophaceous gout using musculoskeletal ultrasound(US).Methods:Thirty-six participants with tophaceous gout and 36 age and sex-matched controls without gout or other arthritis were recruited.All participants underwent a greyscale and power Doppler US examination.The following US characteristics were evaluated:tophus,tendon echogenicity,tendon vascularity,tendon morphology,entheseal characteristics,and bursal morphology.Results:The majority of the participants with tophaceous gout were middleaged men(33/36,92%).Tophus deposition was observed in 74%(53/72)of tendons in those with gout and in none of the controls(P<0.01).Hyperechoic spots(P<0.01)and intratendinous power Doppler signal(P<0.01)were more frequent in participants with gout compared to controls.Intratendinous structural damage was rare.Hyperechoic spots were significantly more common at the insertion compared to the zone proximal to the midsection(P<0.01),but between-zone differences were not observed for other features.Conclusion:US features of urate deposition,tophus,and vascularization are present throughout the AT in patients with tophaceous gout.Intratendinous structural changes are infrequent except crystal deposition.