目的:本研究旨在探讨使用高频超声检查作为检测早期和长期RA患者手足关节炎症和破坏性变化的工具。
方法:本研究采用前瞻性队列设计,纳入162例符合美国风湿病学会/欧洲抗风湿联盟(ACR/EULAR)分类标准的类风湿关节炎(RA)患者。根据疾病持续时间将患者分为两组:第1组(n=74)包括疾病持续时间长达2年的患者,或早期式(ERA;),第2组(n=88)由病程超过2年的患者组成,或长期持久的351(LtRA)。所有患者都接受了关节的临床评估,以及射线照相和关节超声检查,在研究开始时,在6个月和12个月后再次。
结果:在一般患者组中,与临床检查相比,超声检查显示手部关节滑膜炎的征象更频繁(66%)(56%的关节肿胀[NSJ]和55%的关节疼痛[NPJ],P<.01)。经过6个月的治疗,12%的患者实现了US完全缓解,24%实现了US部分缓解。
结论:在RA综合诊断范围内,手和脚关节的关节超声检查,利用灰度和功率多普勒的组合,在检测早期RA方面可能超过射线照相术。该方法允许更准确地评估疾病活动性和进展率。
OBJECTIVE: This study aims to investigate the use of high-frequency sonography as a tool for detecting inflammatory and destructive changes in the hand and foot joints of patients with early and long-term RA.
METHODS: This study employs a prospective cohort design involving 162 patients diagnosed with Rheumatoid arthritis (RA) who meet the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria. Patients were divided into two groups based on disease duration: Group 1 (n = 74) included patients with a disease duration of up to 2 years, or early РА (ERA;), Group 2 (n = 88) consisted of patients with a disease duration exceeding 2 years, or long-term persistent РА (LtRA). All patients underwent a clinical assessment of their joints, as well as radiography and arthrosonography, at the beginning of the study and again at 6 and 12 months later.
RESULTS: In the general group of patients, ultrasound examination revealed signs of synovitis in the joints of the hands more frequently (66%) compared with clinical examination (56% by a number of swollen joints [NSJ] and 55% by a number of painful joints [NPJ], P < .01). After 6 months of treatment, 12% of the patients achieved full US remission and 24% achieved partial US remission.
CONCLUSIONS: Within the scope of comprehensive RA diagnostics, arthrosonography of the joints of the hands and feet, utilizing a combination of greyscale and power Doppler, may surpass radiography in detecting early RA. This method allows for a more accurate assessment of disease activity and progression rates.