Unità Operativa di Reumatologia, Università di Pisa, Pisa, Italy.
Clin Exp Rheumatol. 2011 Jan-Feb;29(1):1-5. Epub 2011 Feb 23.
The aims of our study were to investigate the prevalence of ultrasound (US) abnormalities in the foot of patients with rheumatoid arthritis (RA) and to compare them with the clinical findings.
One hundred RA patients were enrolled in the study. Bilateral US examination of metatarsophalangeal (MTP) joints, proximal interphalangeal (PIP) joints, midfoot joints (talonavicular, calcaneo-cuboid, medial, intermediate and lateral navicular-cuneiform and cuneiform-metatarsal joints and cuboid-4th and 5th metatarsal joints) were examined for synovitis and erosion. In addition the plantar fascia and the insertion of the anterior and posterior tibialis and peroneous brevis tendons were imaged.
Effusion with synovial proliferation was visualised only at MTP joints in 84 out of 200 (42%) feet, at MTP plus at least one joint of the midfoot in other 41 out of 200 (20%) feet (making a total of 125 out of 200 (62%) MTP joints) exclusively in one or more joints of the midfoot in 7 out 200 (3%) feet, in the PIP joint of the 2nd and 3rd toes in 3 (1.5%) and 4 (2%) feet respectively, while no effusion with synovial proliferation was visualised in the PIP joint of the 4th and 5th toes. Synovitis was present most frequently in the 2nd MTP joint whilst erosions were most frequently imaged in the 5th MTP joint.
US examination appears to be a useful imaging technique to study joint and tendon involvement of the foot in RA patients. Moreover, US examination of the foot is more sensitive than clinical examination in the detection of joint inflammation and allows for a better understanding of the features and the progression of the disease.
本研究旨在调查类风湿关节炎（RA）患者足部超声（US）异常的发生率，并将其与临床发现进行比较。
本研究纳入了 100 例 RA 患者。对双侧跖趾（MTP）关节、近侧指间（PIP）关节、中足关节（跟骰、跟骰、内侧、中间和外侧楔骨-骰骨和楔骨-跖骨关节以及骰骨-第 4 和第 5 跖骨关节）进行了 US 检查，以评估滑膜炎和侵蚀情况。此外，还对足底筋膜以及胫骨前肌和腓骨短肌的止点进行了成像。
在 200 只脚中，84 只（42%）仅在 MTP 关节处观察到积液伴滑膜增生，41 只（20%）在 MTP 关节加至少一个中足关节处观察到积液伴滑膜增生（共计 200 只 MTP 关节中有 125 只[62%]），7 只（3%）在一只或多只中足关节处仅观察到积液伴滑膜增生，3 只（1.5%）和 4 只（2%）脚的第 2 和第 3 趾 PIP 关节处分别观察到积液伴滑膜增生，而第 4 和第 5 趾 PIP 关节处未见积液伴滑膜增生。滑膜炎最常发生在第 2 MTP 关节，而侵蚀最常发生在第 5 MTP 关节。
US 检查似乎是一种有用的影像学技术，可以用于研究 RA 患者足部关节和肌腱的受累情况。此外，与临床检查相比，US 检查更敏感，可以检测到关节炎症，并能更好地了解疾病的特征和进展。
