Musculoskeletal ultrasonography delineates ankle symptoms in rheumatoid arthritis.
Musculoskeletal ultrasonography delineates ankle symptoms in rheumatoid arthritis.
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肌肉骨骼超声检查可描绘类风湿性关节炎的踝关节症状。
DOI：
10.1080/14397595.2016.1222650
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Nakajima H.
中科院分区：
文献类型：
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作者：
Toyota Y;Tamura M;Kirino Y;Sugiyama Y;Tsuchida N;Kunishita Y;Kishimoto D;Kamiyama R;Miura Y;Minegishi K;Yoshimi R;Ueda A;Nakajima H.
目的：目的：探讨踝关节肌肉骨骼超声检查在类风湿关节炎（RA）诊断中的应用。评估了超声、临床检查（CE）和患者踝关节疼痛视觉模拟评分（pVAS）。采用灰度（GS）和能量多普勒（PD）超声半定量分级（0-3）评估胫距关节滑膜炎和腱鞘炎的患病率。阳性US和CE结果分别定义为GS评分≥2和/或PD评分≥1，以及关节肿胀和/或压痛。以踝关节pVAS为因变量，采用广义线性混合模型进行多因素分析。结果：在60例RA患者的120个踝关节中，21例（35.0%）患者踝关节超声检查阳性。CE和US的一致率为中等（kappa 0.57）。在88例CE阴性的踝关节中，US在9例（10.2%）关节中检出阳性结果。多变量分析显示，踝关节US，临床疾病活动指数，和足部健康评估问卷，但不CE，是独立相关的踝关节pVAS.Conclusion：US检查是有用的，说明RA踝关节受累，特别是对患者抱怨踝关节疼痛，但缺乏CE结果。
Objectives: To clarify the use of musculoskeletal ultrasonography (US) of ankle joints in rheumatoid arthritis (RA).Methods: Consecutive RA patients with or without ankle symptoms participated in the study. The US, clinical examination (CE), and patients’ visual analog scale for pain (pVAS) for ankles were assessed. Prevalence of tibiotalar joint synovitis and tenosynovitis were assessed by grayscale (GS) and power Doppler (PD) US using a semi-quantitative grading (0–3). The positive US and CE findings were defined as GS score ≥2 and/or PD score ≥1, and joint swelling and/or tenderness, respectively. Multivariate analysis with the generalized linear mixed model was performed by assigning ankle pVAS as a dependent variable.Results: Among a total of 120 ankles from 60 RA patients, positive ankle US findings were found in 21 (35.0%) patients. The concordance rate of CE and US was moderate (kappa 0.57). Of the 88 CE negative ankles, US detected positive findings in 9 (10.2%) joints. Multivariate analysis revealed that ankle US, clinical disease activity index, and foot Health Assessment Questionnaire, but not CE, was independently associated with ankle pVAS.Conclusion: US examination is useful to illustrate RA ankle involvement, especially for patients who complain ankle pain but lack CE findings.