| 张源,孙颖华.肌肉骨骼超声评估幼年型特发性关节炎患儿小关节病变[J].中国医学影像技术,2022,38(6):907~911 |
| 肌肉骨骼超声评估幼年型特发性关节炎患儿小关节病变 |
| Musculoskeletal ultrasound for evaluation on small joint lesions in children with juvenile idiopathic arthritis |
| 投稿时间：2021-11-19 修订日期：2022-02-27 |
| DOI：10.13929/j.issn.1003-3289.2022.06.026 |
| 中文关键词: 关节炎,幼年型类风湿 超声检查 |
| 英文关键词:arthritis, juvenile rheumatoid ultrasonography |
| 基金项目: |
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| 中文摘要: |
| 目的 观察肌肉骨骼超声（MSUS）评估幼年型特发性关节炎（JIA）患儿小关节病变的价值。方法 分析133例JIA患儿掌指关节、近端指间关节、远端指间关节、跖趾关节及近端趾间关节超声表现，并与体格检查结果进行比较。结果 MSUS共扫查133例JIA患儿、2 516个小关节，其中774个关节滑膜增厚，406个可见关节腔积液，477个关节周围肌腱异常，87个关节外软组织病变，543个骨质异常。MSUS检出掌指关节、近端指间关节、跖趾关节阳性率及总阳性率分别为50.69%（517/1 020）、26.97%（164/608）、38.25%（241/630）及38.12%（959/2 516），均高于临床体格检查[33.73%（344/1 020）、21.05%（128/608）、29.84%（188/630）及27.31%（687/2 516），P均<0.05]。超声所示774个滑膜增厚关节中，538个体格检查呈阳性，且体格检查的敏感度随滑膜血流分级下降而降低。结论 MSUS用于检查JIA小关节病变较为敏感。 |
| 英文摘要: |
| Objective To observe the value of musculoskeletal ultrasound (MSUS) for small joint lesions in children with juvenile idiopathic arthritis (JIA). Methods The ultrasonic findings of metacarpophalangeal joint, proximal interphalangeal joint, distal interphalangeal joint, metatarsophalangeal joint and proximal interphalangeal joint in 133 children with JIA were observed and compared with the physical examination results. Results A total of 2 516 small joints were examined with MSUS. The abnormal ultrasound findings included 774 joints of synovial thickening, 406 joints of effusion, 543 joints of bone abnormalities, 477 joints of tendon abnormalities around joints and 87 joints of soft tissue abnormalities outside joints. The positive rate of metacarpophalangeal joint, proximal interphalangeal joint, metatarsophalangeal joint and total joints detected with MSUS was 50.69% (517/1 020), 26.97% (164/608), 38.25% (241/630) and 38.12% (959/2 516), respectively, all higher than those of clinical physical examination[33.73% (344/1 020), 21.05% (128/608), 29.84% (188/630) and 27.31% (687/2 516), all P<0.05]. Of the 774 joints of synovial thickening shown by ultrasound, 538 were positive in physical examination, and the sensitivity of physical examination decreased with the decrease of synovial blood flow grade.Conclusion MSUS was comparatively more sensitive in detecting small joint abnormalities in children with JIA. |
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