Cattedra di Reumatologia, Università di Pisa, Italy.
Clin Exp Rheumatol. 2009 Sep-Oct;27(5):747-50.
To study the frequency and features of joint and tendon involvement in the hand of patients with primary Sjögren's syndrome (pSS) by musculoskeletal ultrasound (US) examination.
Forty-eight patients with pSS diagnosed according to the preliminary classification criteria proposed by the American-European Classification Criteria Group were enrolled in the study. Bilateral US examination of the 1st-5th metacarpophalangeal (MCP), 2nd-5th proximal interphalangeal (PIP) joints and of flexor tendons were performed. A semi-quantitative grading method (0 to 3) for scoring joint effusion, synovial proliferation and intra-articular power Doppler (PD) signal was used.
We observed clear evidence of inflammatory arthritis in 9 (18.7%) patients. Bone erosions at MCP and/or PIP joint were visualized in 6 out of 48 (12.5%) patients. In 10 (20.8%) patients we imaged flexor tenosynovitis which appeared more frequent than in healthy subjects even if no statistically significant difference was detected.
US examination appears to be a useful imaging technique to study joint and soft tissue involvement in connective tissue diseases. The presence of bone erosions in pSS patients is unexpected. Future studies will hopefully concentrate more on defining the erosive capability of connective tissue disorders together with inflammatory involvement of tendons.
通过肌肉骨骼超声（US）检查研究原发性干燥综合征（pSS）患者手部关节和肌腱受累的频率和特征。
本研究纳入了 48 名根据美国-欧洲分类标准组提出的初步分类标准诊断为 pSS 的患者。对双侧第 1-5 掌指（MCP）、第 2-5 近节指间（PIP）关节和屈肌腱进行 US 检查。采用半定量评分方法（0 至 3）对关节积液、滑膜增生和关节内功率多普勒（PD）信号进行评分。
我们在 9 名（18.7%）患者中观察到明显的炎症性关节炎证据。在 48 名患者中，有 6 名（12.5%）患者出现 MCP 和/或 PIP 关节骨侵蚀。在 10 名（20.8%）患者中，我们成像到屈肌腱滑膜炎，尽管没有统计学上的显著差异，但它比健康受试者更常见。
US 检查似乎是一种有用的成像技术，可以研究结缔组织疾病中的关节和软组织受累。pSS 患者存在骨侵蚀是出乎意料的。未来的研究有望更多地集中在定义结缔组织疾病的侵蚀能力以及肌腱的炎症受累。
