痛风性关节炎的超声表现.pdf

痛风性关节炎的超声表现 曹君妍 任杰 黄冬梅 郑荣琴 王巧缘 [摘要] 目的 探讨痛风性关节炎的超声特征。方法 对确诊的5例痛风性关节炎患者19个病变 关节的超声表现进行回顾性分析，总结痛风性关节炎的声像图特点。结果 19个关节中第一跖趾关节5 个，膝关节8个，踝关节、肘关节、腕关节各2个。17个(89.4％)关节超声表现为软骨表面回声增强，与深 面的骨性关节面强回声线形成“双边征”。13个(68.4％)关节表现为不同程度的关节腔积液，积液内可见 漂浮点状强回声，振动后运动明显。11个(57.9％)关节内见滑膜增厚，彩色多普勒显示滑膜内部血流信号 丰富或稀少。其中1例膝关节髌上囊处滑膜呈结节状明显增厚，范围约5cm×2cm，内见大量强回声点， 后方伴声影。6个(31.6％)关节软骨超声表现为不规则形变薄，软骨下骨面粗糙、回声中断。4个 (21.1％)关节周围软组织见稍高或强回声团，后伴或不伴声影。其中3个关节同时出现邻近骨皮质回声 毛糙不平滑、连续性中断或缺损。结论 痛风性关节炎具有一定的超声表现，超声可能早期提示此病，具 有一定的临床应用价值。 超声检查；关节炎，痛风性 Ultrasonographicfindingsingoutyarthritis CAOJun-yanREN JieHUANGDong-meiZHENGRong- qin WANGQiao-yuanDepartmentofUltrasonography,InstituteofDiagnosticandInterventional Ultrasound,theThirdAffiliatedHospitalofSunYat-senUniversity,Guangzhou510630,China [Abstract] Objective Toexplorethesonographicfeaturesofgoutyarthritis.Methods The sonographicfeaturesofgoutyarthritisweresummarizedbyretrospectivelystudyingthesonogramof19 jointsof5patients.Results Fivethefirstmetatarsophalangealjoints,8knees,2ankles,2elbowsand2 wristswereinvestigated.Outof19joints,17(89.4％)haddoublecontoursigns,ahyperechoicandirregular bandoverthesuperficialmarginofthearticularcartilage.Jointeffusionswereseenin13of19joints (68.4％).Multiplehyperreflectivefocicouldbeseeninthejointfluid,whichwereobviousbyshakingthe probe.In19joints,11(57.9％)hadproliferationofthesynoviumidentified,andproliferativesynoviumwere revealedashyperperfusionorhypoperfusionbycolorDopplerultrasound.Inoneknee,thesynovium proliferatedobviouslywithinvolvedareaabout5cm× 2cm,andhyperechoicaggregateswithacoustic shadowcouldbeseeninit.Articularcartilagebecameirregularlythinandthehyperechoicoutlineof subchondralbonecortexbecameroughorevenbrokein6of19joint(31.6％).Homogeneous,hyperechoic aggregateswithorwithoutacousticshadowinthesofttissuearoundthejointwereseeninfourjoints (21.1％).Threeinthese4jointsexitedbonecortexerosionsadjacenttoaggregates.Conclusions Gouty arthritishassomespecificsonographicfeatures,ult