肌肉骨骼超声在足踝部痛风性关节炎临床诊断中的应用及超声表现  

Application of Musculoskeletal Ultrasound in the Clinical Diagnosis of Gouty Arthritis of Foot and Ankle and its Ultrasonic Manifestations

作　　者：曹欣宇 CAO Xin-yu(Department of ultrasound,967th hospital of PLA joint logistic support force,Dalian,Liaoning province 116000)

机构地区：[1]中国人民解放军联勤保障部队第九六七医院超声诊断科,辽宁大连116000

出　　处：《中国伤残医学》2023年第1期25-29,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨肌肉骨骼超声在足踝部痛风性关节炎临床诊断中的应用及超声表现。方法:选取我院2019年9月-2020年9月收治的足踝部痛风性关节炎患者90例作为研究对象,根据患者有无发生痛风分为足踝部痛风性关节炎组(52例)与非痛风性关节炎组(38例),2组人群均接受肌肉骨骼超声诊断。比较2组诊断结果,关节受累、超声表现、敏感度、特异度。结果:2组阳性病变检出率相比,差异有统计学意义(P<0.05);足踝部痛风性关节炎组52例患者中,踝关节病变14例,附骨间关节病变7例,第1跖趾关节病变31例;非痛风性关节炎组38例患者中,附骨间关节病变20例,踝关节病变18例。2组第1跖趾关节、足背部附骨间关节、踝关节的腱鞘炎、骨侵蚀、关节腔积液、滑膜增厚、皮下软组织水肿等超声表现相比,差异无统计学意义(P>0.05);2组踝关节的聚集体形成、痛风石、关节软骨双轨征表现相比,差异有统计学意义(P<0.05);2组敏感度相比,差异有统计学意义(P<0.05),特异度相比不具备差异(P>0.05)。结论:足踝部痛风性关节炎临床诊断中,肌肉骨骼超声诊断结果较为准确,值得应用,为临床研究提供了参考。Objective:To investigate the application of musculoskeletal ultrasound in the clinical diagnosis of gouty arthritis of foot and ankle and its ultrasonic manifestations.Methods:90 patients with foot and ankle gouty arthritis The 967th Hospital of the PLA Joint Logistic Support Force hospital from September 2019 to September 2020 were selected as the research objects.According to whether the patients had gout,they were divided into foot and ankle gouty arthritis(52 cases)and non-gouty arthritis(38 cases).Both groups received musculoskeletal ultrasound diagnosis.The joint involvement,ultrasound findings,sensitivity and specificity were compared between the two groups.Results:There was a statistically significant difference in the positive lesion detection rate between the two groups(P<0.05);In 52 patients with gouty arthritis of foot and ankle,14 patients had ankle joint disease,7 patients had accessory bone joint disease,and 31 patients had first metatarsophalangeal joint disease;In the 38 cases of non gouty arthritis group,there were 20 cases of periosteal joint disease and 18 cases of ankle joint disease.There was no significant difference between the two groups in the ultrasonic manifestations of the first metatarsophalangeal joint,foot dorsal interosseous joint and ankle joint,such as tenosynovitis,bone erosion,joint cavity effusion,synovial thickening,subcutaneous soft tissue edema,etc.(P>0.05);Compared with the two groups,the first metatarsophalangeal joint,foot dorsal interosseous joint,ankle joint aggregate formation,gout stone,articular cartilage double track sign showed significant difference(P<0.05);There was a statistically significant difference in sensitivity between the two groups(P<0.05),while there was no difference in specificity(P>0.05).Conclusion:in the clinical diagnosis of foot and ankle gouty arthritis,musculoskeletal ultrasound diagnosis results are more accurate,it is worthy of application,It provides a reference for clinical research.

关 键 词：足踝部痛风性关节炎 肌肉骨骼超声 超声表现 敏感度 

分 类 号：R589.7[医药卫生—内分泌]