彩色超声波诊断仪鉴别诊断类风湿性与痛风性跖趾关节病变的临床观察

Clinical Observation on the Differential Diagnosis of Rheumatoid and Gouty Metatarsophalangeal Joint Lesions by Color Ultrasound Diagnosis Instrument

目的:探讨彩色超声波诊断仪鉴别诊断类风湿性与痛风性跖趾关节(MTP)病变的临床价值。方法:选取2020年4月~2022年4月本院收治的类风湿性与痛风性跖趾关节病变患者共90例,按照疾病种类分组,其中,类风湿关节炎(RA)跖趾关节病变48例,设为RA组;痛风性关节炎(GA)跖趾关节病变42例,设为GA组。两组入院后均采用彩色超声波诊断仪检查,比较两组超声影像特征,判定其诊断价值。结果:RA组直接征象中边界模糊、外观呈圆形的人数占比明显高于GA组(P<0.05),两组血流信号相比差异无意义(P>0.05);且RA组间接征象中痛风石、双轨征、点状强回声以及滑膜增生人数占比均高于GA组(P<0.05),关节积液上两组未见差异(P>0.05);RA组骨侵蚀受累关节主要集中在MTP5,而GA组骨侵蚀受累关节集中在MTP1,二者在MTP1、MTP2、MTP5的关节上出现明显差异(P<0.05)。结论:利用彩色超声波诊断仪为临床诊断类风湿性与痛风性跖趾关节病早期鉴别提供参考,可取得较准确的诊断信息。

Objective:To explore the clinical value of color ultrasound diagnostic equipment in the differential diagnosis of rheumatoid and gouty metatarsophalangeal joint diseases.Methods:A total of 90 patients with rheumatoid and gouty metatarsophalangeal joint disease admitted to our hospital from April 2020 to April 2022 were selected.According to the type of disease,48 of them were classified as rheumatoid metatarsophalangeal joint disease and assigned to the RA group;Another 42 cases of gouty metatarsophalangeal joint disease were assigned to the GA group.After admission,both groups were examined using color ultrasound diagnostic equipment.The ultrasound imaging characteristics of the two groups were compared to determine their diagnostic value.Results:The proportion of people with blurry boundaries and circular appearance in the direct signs of RA group was significantly higher than that of GA group(P<0.05),and there was no significant difference in blood flow signals between the two groups(P>0.05);The proportion of indirect signs such as gout stones,double track sign,punctate hyperechogenicity,and synovial hyperplasia in the RA group was higher than that in the GA group(P<0.05),and there was no difference in joint effusion between the two groups(P>0.05);The bone erosion affected joints in the RA group were mainly concentrated in MTP5,while in the GA group,the bone erosion affected joints were concentrated in MTP1.There was a significant difference between the two in the joints of MTP1,MTP2,and MTP5(P<0.05).Conclusion:The use of color ultrasound diagnostic equipment provides a reference for the early differentiation of rheumatoid and gouty metatarsophalangeal arthropathy in clinical diagnosis,and can obtain accurate diagnostic information.