肌肉骨骼超声影像学表现在痛风性关节炎诊断中的价值  

Value of musculoskeletal ultrasound imaging manifestations in diagnosis of gouty arthritis

作　　者：张颖[1] 王俊祥[1] ZHANG Ying;WANG Jun-xiang(Department of Rheumatology and Immunology,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院风湿免疫科,石家庄市050051

出　　处：《广西医学》2022年第5期487-490,共4页Guangxi Medical Journal

基　　金：河北省医学科学研究重点课题计划(20180468)。

摘　　要：目的探讨肌肉骨骼超声(MSUS)影像学表现在痛风性关节炎诊断中的应用价值。方法将69例痛风性关节炎患者作为痛风组、73例非痛风性关节炎患者作为对照组,所有患者均行MSUS检查。比较两组MSUS中滑膜炎、关节腔积液、腱鞘炎、附着点炎、双轨征、痛风石、聚集体和骨侵蚀等表现,分析MSUS特征性表现诊断痛风性关节炎的价值。结果超声结果显示,痛风组出现双轨征、痛风石、聚集体MSUS影像特征的患者比例高于对照组,出现腱鞘炎MSUS影像特征的患者比例低于对照组(均P<0.05);痛风组患者出现滑膜炎、腱鞘炎、附着点炎、骨侵蚀MSUS影像特征的关节比例均低于对照组,而出现双轨征、痛风石、聚集体MSUS影像特征的关节比例均高于对照组(均P<0.05)。MSUS检查仅表现为双轨征或痛风石或聚集体者诊断为痛风性关节炎的敏感性均较低(均≤55.1%),特异性均较高(均≥98.6%);联合上述三者诊断痛风性关节炎的敏感性为69.6%,特异性为98.6%。结论MSUS是诊断痛风性关节炎的有效方法,超声表现为双轨征、痛风石、聚集体对痛风性关节炎的诊断有很高的特异性,三者联合可以提高诊断敏感性。Objective To investigate the application value of musculoskeletal ultrasound(MSUS)imaging manifestations in the diagnosis of gouty arthritis.Methods Sixty-nine patients with gouty arthritis were enrolled in gout group and 73 arthritis patients without gout in control group.All patients undertook MSUS examinations.The manifestations,including synovitis,joint effusion,tenosynovitis,enthesitis,double track sign,tophus,aggregation,and bone erosion,were observed on MSUS in both groups.The diagnostic value of characteristic manifestations of MSUS for gouty arthritis was analyzed.Results The ultrasonic findings revealed that the gout group had higher proportions of patients whose MSUS imaging features were presented as double track sign,tophus,and aggregation,and a lower proportion of patients whose MSUS imaging features were presented as tenosynovitis as compared with the control group(all P<0.05);patients in the gout group yielded lower proportions of joints whose MSUS imaging features were presented as synovitis,tenosynovitis,enthesitis,and bone erosion,and higher proportions of joints MSUS imaging features were presented as double track sign,tophus,and aggregation as compared with the control group(all P<0.05).Patients,who were presented with double track sign,tophus,or aggregation alone on MSUS examinations,had lower sensitivities(all≤55.1%)and higher specificities(all≥98.6%)for the diagnosis of gouty arthritis,whereas the combination of the three manifestations described above yielded a sensitivity of 69.6%and a specificity of 98.6%for the diagnosis of gouty arthritis.Conclusion MSUS is a potent approach to diagnosing gouty arthritis.The ultrasound manifestations of double track sign,tophus,and aggregation have a quite high specificity in the diagnosis of gouty arthritis.The combination of the three manifestations can improve the diagnostic sensitivity.

关 键 词：痛风 肌肉骨骼超声 超声 

分 类 号：R445.1[医药卫生—影像医学与核医学]