肌肉骨骼超声在中老年痛风性关节炎患者腱鞘炎及骨侵蚀诊断中的价值分析  

Analysis of the value of musculoskeletal ultrasound in the diagnosis of tenosynovitis and bone erosion in middle-aged and elderly gouty arthritis patients

作　　者：盛燕玲 宋庆 刘招友 SHENG Yanling;SONG Qing;LIU Zhaoyou(Department of Ultrasound Diagnosis,the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Jiangxi Province,Nanchang330006,China)

机构地区：[1]江西中医药大学附属医院超声诊断科,江西南昌330006

出　　处：《中国当代医药》2024年第31期88-90,95,共4页China Modern Medicine

基　　金：江西省中医药管理局科研项目(2019A203)。

摘　　要：目的分析肌肉骨骼超声(MSUS)在中老年痛风性关节炎患者腱鞘炎及骨侵蚀诊断中的价值。方法选取2020年1月至2022年12月江西中医药大学附属医院收治的82例痛风性关节的中老年患者作为研究对象,所有患者均行MSUS检查,以磁共振成像(MRI)诊断为金标准,分析MSUS对中老年痛风性关节患者腱鞘炎及骨侵蚀的诊断价值。结果82例患者中,MRI诊断腱鞘炎阳性23例,阴性59例;MSUS诊断腱鞘炎阳性25例,阴性57例,其中漏诊1例,误诊3例,诊断一致性检验Kappa值为0.882,敏感度为95.65%,特异度为94.92%,准确度为95.12%,阳性预测值为88.00%,阴性预测值为98.25%;82例患者中MRI诊断骨侵蚀阳性30例,阴性52例;MSUS诊断骨侵蚀阳性28例,阴性54例,其中漏诊3例,误诊1例,诊断一致性检验Kappa值为0.893,敏感度为90.00%,特异度为98.08%,准确度为95.12%,阳性预测值为96.43%,阴性预测值为94.44%。结论MSUS在中老年痛风性关节炎患者腱鞘炎及骨侵蚀诊断中均具有较高的敏感度和特异度,其临床诊断价值较高。Objective To analyze the value of musculoskeletal ultrasound(MSUS)in the diagnosis of tenosynovitis and bone erosion in middle-aged and elderly gouty arthritis patients.Methods A total of 82 middle-aged and elderly patients with gouty arthritis admitted to the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from January 2020 to December 2022 were selected as research objects.All patients underwent MSUS examination.Taking magnetic resonance imaging(MRI)diagnosis as the golden standard,the diagnostic value of MSUS for tenosynovitis and bone erosion in middle-aged and elderly patients with gouty arthritis were analyzed.Results In the 82 patients,MRI diagnosis showed that there were 23 cases with tenosynovitis and 59 negative cases.MSUS diagnosis showed that there were 25 cases with tenosynovitis and 57 negative cases,including 1 case with missed diagnosis and 3 cases with misdiagnosis,and its diagnostic consistency Kappa value,sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 0.882,95.65%,94.92%,95.12%,88.00% and 98.25%,respectively.In the 82 patients,MRI diagnosis showed that there were 30 cases with bone erosion and 52 negative cases.MSUS diagnosis showed that there were 28 cases with bone erosion and 54 negative cases,including 3 cases with missed diagnosis and 1 case with misdiagnosis,and its diagnostic consistency Kappa value,sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 0.893,90.00%,98.08%,95.12%,96.43% and 94.44%,respectively.Conclusion MSUS has high sensitivity and specificity in the diagnosis of tenosynovitis and bone erosion in middle-aged and elderly patients with gouty arthritis,and its clinical diagnostic value is high.

关 键 词：肌肉骨骼超声 中老年 痛风性关节炎 腱鞘炎 骨侵蚀 诊断价值 

分 类 号：R445[医药卫生—影像医学与核医学]