Dalbeth Nicola, McQueen Fiona M
University of Auckland, New Zealand.
Curr Opin Rheumatol. 2009 Mar;21(2):124-31. doi: 10.1097/BOR.0b013e3283257b6c.
This review summarizes recent advances in plain radiography and advanced imaging for gout, calcium pyrophosphate dihydrate crystal arthropathy and basic calcium phosphate crystal arthropathy.
Plain radiography has diagnostic utility in the crystal-induced arthropathies. A gout radiographic damage index has been recently validated. High-resolution ultrasonography may improve noninvasive diagnosis of the crystal-induced arthropathies, and allow monitoring of intra-articular tophi in clinical trials. Computed tomography provides excellent definition of tophi and bone erosion, and three-dimensional computed tomography assessment of tophus volume is a promising outcome measure in gout. Magnetic resonance imaging is also a reliable method for assessment of tophus size in gout, and has an important role in detection of complications of disease in clinical practice. Emerging imaging techniques include three-dimensional ultrasonography and dual-energy computed tomography. Advanced imaging modalities also offer new insights into the mechanisms of cartilage and bone damage in the crystal-induced arthropathies.
Plain radiography and advanced imaging techniques may assist with diagnosis, assessment of disease complications and monitoring of crystal-induced arthropathies. Further study of these techniques will provide significant improvement in patient care and further aid in the understanding of disease pathogenesis.
本综述总结了痛风、二水焦磷酸钙晶体性关节病和碱性磷酸钙晶体性关节病在普通X线摄影及先进成像技术方面的最新进展。
普通X线摄影在晶体性关节病中有诊断价值。最近痛风X线损伤指数已得到验证。高分辨率超声可改善晶体性关节病的无创诊断，并能在临床试验中监测关节内痛风石。计算机断层扫描能清晰显示痛风石和骨质侵蚀，痛风石体积的三维计算机断层扫描评估是一种很有前景的痛风疗效评估指标。磁共振成像也是评估痛风中痛风石大小的可靠方法，在临床实践中对疾病并发症的检测具有重要作用。新兴的成像技术包括三维超声和双能计算机断层扫描。先进的成像方式也为晶体性关节病中软骨和骨损伤的机制提供了新的见解。
普通X线摄影和先进的成像技术可能有助于晶体性关节病的诊断、疾病并发症评估及监测。对这些技术的进一步研究将显著改善患者护理，并有助于进一步理解疾病发病机制。
