肌骨超声在痛风性关节炎与焦磷酸钙沉积病鉴别诊断中的应用价值  

Application value of musculoskeletal ultrasound in the differential diagnosis of gouty arthritis and calcium pyrophosphate deposition disease

作　　者：李慧敏[1] 赖仕峰 张洪萍 LI Hui-min;LAI Shi-feng;ZHANG Hong-ping(Department of Ultrasound,Jianyang People's Hospital,Jianyang Sichuan 641400,China)

机构地区：[1]简阳市人民医院超声科,四川简阳641400

出　　处：《临床和实验医学杂志》2023年第21期2338-2341,共4页Journal of Clinical and Experimental Medicine

基　　金：四川省卫健委科研课题(编号:20PJ147)。

摘　　要：目的探讨肌骨超声在痛风性关节炎与焦磷酸钙沉积病鉴别诊断中的应用价值。方法回顾性选取2020年1月至2023年1月简阳市人民医院收治的痛风性关节炎患者200例作为痛风性关节炎组、焦磷酸钙沉积患者10例作为焦磷酸钙沉积组。统计分析两组患者受累关节、超声直接征象、超声间接征象及滑膜血流分级。结果痛风性关节炎组患者的第一跖趾关节、踝关节、第1至5掌指关节受累率均明显高于焦磷酸钙沉积组,膝关节、腕关节、肘关节、肩关节受累率均明显低于焦磷酸钙沉积组,差异均有统计学意义(P<0.05),但两组患者的第1至5近端指间关节、足跟受累率之间的差异均无统计学意义(P>0.05)。痛风性关节炎组患者的超声直接征象中双轨征、痛风石、骨侵蚀、肌腱内强回声、韧带内强回声、滑膜内强回声比率均明显高于焦磷酸钙沉积组,软骨钙化比率明显低于焦磷酸钙沉积组,差异均有统计学意义(P<0.05)。痛风性关节炎组患者的超声间接征象滑膜炎、关节积液、软组织肿胀比率均明显高于焦磷酸钙沉积组,骨赘形成、滑囊炎、骨皮质不规则、软骨损伤、半月板退行性变比率均明显低于焦磷酸钙沉积组,差异均有统计学意义(P<0.05),但两组患者的肌腱病、腱鞘积液、腱鞘炎比率之间的差异均无统计学意义(P>0.05)。痛风性关节炎组患者的滑膜血流分级0、1级、2级、3级比率之间的差异无统计学意义(Z=0.232,P>0.05)。结论肌骨超声在痛风性关节炎与焦磷酸钙沉积病鉴别诊断中具有较高的应用价值。Objective To investigate the value of musculoskeletal ultrasound in the differential diagnosis of gouty arthritis and calcium pyrophosphate deposit disease.Methods Two hundreds patients with gouty arthritis admitted to Jianyang People's Hospital from January 2020 to January 2023 were retrospectively selected as gouty arthritis group and 10 patients with calcium pyrophosphate deposition were selected as the calcium pyrohosphate deposition group.The affected joints,ultrasonic direct signs,ultrasonic indirect signs and synovial blood flow grading were analyzed.Results The involvement rates of the first metatarsophalangeal joint,ankle joint and first to fifth metacarpophalangeal joint in gouty arthritis group were higher than those in calcium pyrophosphate deposition group,and the involvement rates of knee joint,wrist joint,elbow joint and shoulder joint were lower than those in calcium pyrophosphate deposition group,the differences were statistically significant(P<0.05).However,there were no statistically significant differences in the involvement rates of the first to fifth proximal interphalangeal joints and the heel between the two groups(P>0.05).In gouty arthritis group,the ratio of double-track sign,gouty stone,bone erosion,strong echo in tendon,strong echo in ligament and strong echo in synovium were higher than those in calcium pyrophosphate deposition group,and the ratio of cartilage calcification was lower than that in calcium pyrophosphate deposition group,the differences were statistically significant(P<0.05).The rates of indirect ultrasonic signs of synovitis,joint effusion and soft tissue swelling in gout arthritis group were higher than those in calcium pyrophosphate deposition group,and the rates of osteophyte formation,bursitis,irregularity of bone cortex,cartilage injury and meniscus degeneration were lower than those in calcium pyrophosphate deposition group,the differences were statistically significant(P<0.05).However,there were no statistically significant differences in the rates of tendinopath

关 键 词：关节炎 痛风性 焦磷酸钙 肌骨超声 鉴别诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R589.7[医药卫生—诊断学]