6例与附着点炎相关的幼年特发性关节炎磁共振及临床表现

Magnetic Resonance Imaging and Clinical Manifestations of 6 Cases of Juvenile Idiopathic Arthritis Associated with Attachment Inflammation

目的探讨6例与附着点炎相关幼年特发性关节炎磁共振(MRI)及临床特点,提高此病的认识。方法收集2020年1月至2022年9月我院风湿科确诊与附着点炎相关幼年特发性关节炎(ERA)6例患者临床及MRI资料,采用描述性统计学方法回顾性分析其病变关节磁共振表现、临床体征、实验室指标。结果6例患儿年龄为9-13岁,关节症状持续时间均大于6周。病变关节12个,MRI主要表现为关节腔积液10(10/12)、骨髓水肿10(10/12)、滑膜增厚7(7/12)、附着点炎6(6/12)、腱鞘积液4(4/12)、血管翳形成2(2/12);其临床主要体征为外周关节疼痛、肿胀伴活动障碍6(6/6);重要实验室异常指标为人类白细胞抗原(HLA)-B27阳性6(6/6)、红细胞沉降率(ESR)升高5(5/6)、抗核抗体(ANA)升高4(4/6)、C-反应蛋白测定(CRP)升高3(3/6)。结论ERA磁共振表现、实验室指标均具有一定特征性,结合临床体征可对此病进行确定性诊断。

Objective To investigate the magnetic resonance imaging(MRI)and clinical features of 6 patients with enthesitis-related juvenile idiopathic arthritis,To raise awareness of the disease.Methods The clinical and MRI data of 6 patients with enthesitis-associated juvenile idiopathic arthritis(ERA)diagnosed in the Department of Rheumatology of our hospital from January 2020 to September 2022 were collected,The magnetic resonance imaging,clinical signs and laboratory indexes of the affected joints were retrospectively analyzed by descriptive statistics.Results The six patients were aged from 9 to 13 years,and the duration of joint symptoms was greater than 6 weeks.There were 12 diseased joints,and the main manifestations of MRI were joint effusion 10(10/12),bone marrow edema 10(10/12),synovial thickening 7(7/12),attachment point inflammation 6(6/12),tenosynovial effusion 4(4/12),Pus formation 2(2/12).The main clinical signs were peripheral joint pain and swelling with mobility disorder 6(6/6).Important laboratory abnormal indicators were human leukocyte antigen(HLA)-B27 positive 6(6/6),erythrocyte sedimentation rate increased 5(5/6),antinuclear antibody(ANA)increased 4(4/6),C-reactive protein(CRP)increased 3(3/6).Conclusion ERA has certain characteristics of magnetic resonance imaging and laboratory indicators,and combined with clinical signs,definitive diagnosis of this disease can be made.