肌骨超声用于诊断痛风性关节炎的临床价值

Clinical value of musculoskeletal ultrasound in the diagnosis of gouty arthritis

目的:研究肌骨超声诊断痛风性关节炎的临床价值。方法:选取82例关节炎病人,其中痛风性关节炎病人41例作为痛风组,非痛风性关节炎病人41例作为非痛风组。采用肌骨超声检查2组病人软组织肿胀、腱鞘炎以及滑囊肿胀等情况,评价超声诊断痛风的特异性与敏感性。结果:痛风组病人共检出59处关节病变,非痛风组病人共检出70处关节病变,2组差异无统计学意义(P>0.05)。痛风组病人韧带内高回声点、痛风石、高回声点和平行线发生率均明显高于非痛风组(P<0.01),腱鞘炎和骨侵蚀发生率均明显低于非痛风组病人(P<0.01);2组病人滑膜增生、血流、滑囊炎、骨化和附着点骨面侵蚀发生率差异均无统计学意义(P>0.05)。痛风组病人肌骨超声的临床表现痛风石、平行线、韧带内高回声点以及高回声点等一个及以上的敏感性为89.98%,特异性为65.09%。结论:韧带内高回声点、痛风石、高回声点、平行线、腱鞘炎以及骨侵蚀等肌骨超声表现对于痛风性关节炎的诊断具有一定的临床参考价值。

Objective:To study the clinical value of musculoskeletal ultrasound in the diagnosis of gouty arthritis.Methods:Eighty-two patients with arthritis were selected,including 41 patients with gouty arthritis as the gout group,and 41 patients with non-gouty arthritis as the non-gout group.Musculoskeletal ultrasound was used to examine the soft tissue swelling,tenosynovitis,and bursal swelling in the two groups,and the specificity and sensitivity of ultrasound in diagnosing gout were evaluated.Results:A total of 59 joint lesions were found in the gout group,and 70 joint lesions were found in the non-gout group,the difference of which was not statistically significant(P>0.05).The incidences of hyperechoic point in ligament,tophus,hyperechoic point and parallel lines in gout group were significantly higher than those in non-gout group(P<0.01),and the incidences of tenosynovitis and bone erosion were significantly lower than those in non-gout group(P<0.01).There was no significant difference in the incidence of synovial hyperplasia,blood flow,synovitis,ossification,and attachment bone erosion between the two groups(P>0.05).The sensitivity and specificity of one or more of the clinical findings of musculoskeletal ultrasound of patients in the gout group,such as tophus,parallel line,hyperechoic point in ligament,and hyperechoic point was 89.98%and 65.09%,respectively.Conclusions:Musculoskeletal ultrasound findings such as hyperechoic point in ligament,tophus,hyperechoic point,parallel line,tenosynovitis,and bone erosion have certain clinical reference value in the diagnosis of gouty arthritis.