银屑病关节炎中，骶髂关节炎的临床评估和HLA - B27对于通过磁共振成像诊断的骶髂关节炎而言，是较差的预测指标。
Clinical assessment of sacroiliitis and HLA-B27 are poor predictors of sacroiliitis diagnosed by magnetic resonance imaging in psoriatic arthritis.
作者信息
Williamson L, Dockerty J L, Dalbeth N, McNally E, Ostlere S, Wordsworth B P
机构信息
Nuffield Orthopaedic Centre, Headington, Oxford OX3 7LD, UK.
出版信息
Rheumatology (Oxford). 2004 Jan;43(1):85-8. doi: 10.1093/rheumatology/keg475. Epub 2003 Sep 16.
OBJECTIVE
To determine the frequency and clinical predictors of sacroiliitis diagnosed by magnetic resonance imaging (MRI) in a psoriatic arthritis (PsA) population.
METHODS
The studied comprised 103 patients with PsA. A careful clinical assessment for sacroiliitis was made from history and examination, and HLA-B27 testing was performed. Sixty-eight patients underwent tilted coronal fat-saturated T1-weighted and STIR MRI of the sacroiliac joints.
RESULTS
Clinical features of moderate or severe sacroiliitis were found in 24/68 (35%) patients. MRI features of sacroiliitis were found in 26/68 (38%) patients. Clinical features of sacroiliitis were present in 14/42 (33%) with normal MRI scans and 10/26 (38%) with abnormal scans (normal vs abnormal scans, P = 0.7). The presence of sacroiliitis on MRI was associated with restricted spinal movements (P = 0.004) and the duration of PsA (P = 0.04). There was no correlation between HLA-B27 and sacroiliitis diagnosed by MRI.
CONCLUSION
Sacroiliitis diagnosed by MRI occurs commonly in PsA but is difficult to detect clinically.
目的
确定银屑病关节炎（PsA）患者中通过磁共振成像（MRI）诊断的骶髂关节炎的发生率及临床预测因素。
方法
研究纳入103例PsA患者。通过病史和检查对骶髂关节炎进行仔细的临床评估，并进行HLA - B27检测。68例患者接受了骶髂关节倾斜冠状位脂肪饱和T1加权和短T1反转恢复（STIR）MRI检查。
结果
68例患者中有24例（35%）存在中度或重度骶髂关节炎的临床特征。68例患者中有26例（38%）存在骶髂关节炎的MRI特征。MRI扫描正常的42例患者中有14例（33%）存在骶髂关节炎的临床特征，MRI扫描异常的26例患者中有10例（38%）存在骶髂关节炎的临床特征（正常与异常扫描，P = 0.7）。MRI显示存在骶髂关节炎与脊柱活动受限（P = 0.004）及PsA病程（P = 0.04）相关。HLA - B27与MRI诊断的骶髂关节炎之间无相关性。
结论
MRI诊断的骶髂关节炎在PsA中常见，但临床难以检测到。
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