Ultrasound definition of tendon damage in patients with rheumatoid arthritis. Results of a OMERACT consensus-based ultrasound score focussing on the diagnostic reliability

摘要

Tenosynovitis is one of the key features of the clinical pattern in patients with rheumatoid arthritis (RA). Histologically, tenosynovitis exhibits similar features as joint synovitis, including hyper-plasia of the synovial lining and infiltration of particular types of leukocytes, notably CD4 T cells and CD 68 + macrophages. Longstanding tenosynovitis may result in tendon damage either by synovial proliferation or by bony attrition resulting in tendon rupture with consequent disability.The most common ruptures of the tendons of the hand involve the extensor pollicis longus (EPL) tendon and the extensor digiti minimi (EDM) tendon. It is assumed that partial tears in tendons progressively evolve into complete ruptures. Although clinical examination (CE) may disclose complete rupture, CE of partial tears is notoriously unreliable. 5-7