The Outcome of Knee Synovitis in Early Arthritis Provides Guidelines for Management
The Outcome of Knee Synovitis in Early Arthritis Provides Guidelines for Management
复制标题
早期关节炎中膝关节滑膜炎的结果为治疗提供了指导
作者：
J. Devlin;A. Gough;A. Huissoon;P. Perkins;R. Jubb;P. Emery
摘要：本研究的目的是检查早期关节炎诊所就诊的患有膝关节滑膜炎的患者的临床结果。在就诊时对患者进行关节炎症证据和模式的评估。然后在第 3、6 和 12 个月以及此后每年对这些患者进行重新评估，以确定临床结果。对 1633 名连续转诊患者进行了检查，其中 903 名患有早期滑膜炎。 130 人就诊时患有膝关节滑膜炎，其中 73 人在研究期间符合 ACR 类风湿性关节炎 (RA) 标准。所有 73 名患者都患有对称性多关节炎，包括小关节，并且在 1 岁时病情持续存在。其余 57 名患者中，61% 的少关节炎患者和 33% 的多关节炎患者（包括膝关节滑膜炎）在 1 年时得到缓解。那些表现为膝关节单关节炎的患者在 1 年内均未出现炎症，也没有任何时候符合 RA 的 ACR 标准。结论是，没有小关节多关节炎的膝关节滑膜炎患者在标准治疗后通常会出现良性病程。没有出现单关节炎的患者发展为 RA。膝关节滑膜炎作为多关节炎的一部分（即使不满足 ACR 标准）可能证明在就诊时使用缓解疾病的抗风湿药物是合理的。
Abstract: The aim of the study was to examine the clinical outcome of patients presenting to an early arthritis clinic with synovitis of the knee. The patients were assessed at presentation for evidence and pattern of joint inflammation. These patients were then reassessed at 3, 6 and 12 months and thereafter annually to determine clinical outcome. One thousand six hundred and thirty-three consecutive referrals were examined, 903 of whom had early synovitis. One hundred and thirty had knee synovitis at presentation, of whom 73 fulfilled ACR criteria for rheumatoid arthritis (RA) during the study. All 73 presented with a symmetrical polyarthritis that included the small joints and had persistent disease at 1 year. Of the remaining 57 patients, 61% of those presenting with an oligoarthritis and 33% with a polyarthritis (including knee synovitis) were in remission at 1 year. None of those presenting as a monoarthritis of the knee had inflammation at 1 year or fulfilled ACR criteria for RA at any time. It was concluded that patients presenting with knee synovitis in the absence of a small joint polyarthritis usually have a benign course following standard therapy. No patient who presented with monoarthritis developed RA. Knee synovitis as part of a polyarthritis (even when not fulfilling ACR criteria) probably justifies disease-modifying antirheumatic drug at presentation.