超声检查类风湿关节炎患者肩关节病变的应用价值

摘要

Objective To investigate the application value of ultrasound in the diagnosis of shoulder abnormality among patients with rheumatoid arthritis(RA).Methods Shoulders of 41 RA patients and 20 healthy volunteers were examined by high frequency ultrasound and physicians.Abnormal ultrasonography and clinical appearance were recorded.Results Abnormalities,such as tendonitis of long head of biceps tendon(14 shoulders),synovitis ( 15 shoulders),rotate cuff degeneration (6 shoulders),bone erosion (25 shoulders) and joint effusion(10 shoulders),were found in RA patients and only 16 shoulders were found abnormal by clinical examination.The positive rate of ultrasound (43.9％) was significantly higher than that of clinical examination (19.5％,P =0.001 ).Only a small amount of effusion was found in tendon sheathes of 2 biceps in the control group.Conclusions Most of shoulder abnormalities can be detected by ultrasound and the sensitivity of ultrasound is higher than that of clinical examination.Ultrasonography is valuable in the diagnosis of shoulder RA.%目的 探讨超声检查在诊断类风湿关节炎(rheumatoid arthritis,RA)患者肩关节病变中的应用价值.方法 RA患者41例,健康志愿者20例,分别应用高频超声检查双侧肩关节,并进行临床体检,观察RA患者肩关节病变的声像图表现及临床体征,比较两种检查方法的阳性率.结果 RA患者中36个肩关节有异常超声表现,主要为肱二头肌长头腱肌腱炎、滑膜炎、肩袖病变、骨侵蚀及关节腔积液；16个肩关节临床检查有阳性体征,超声检查阳性率明显高于临床体检(P=0.001).对照组仅2个肩关节可见肱二头肌长头腱腱鞘少量积液.结论 超声可以发现RA患者多数肩关节异常改变,且其敏感性高于临床体检,具有较高的临床应用价值.