Perić Porin, Pervan Marijana
Klinika za reumatske bolesti i rehabilitaciju, Referentni centar MZSS RH za reumatoidni artritis, Kispatićeva 12, 10000 Zagreb.
Reumatizam. 2010;57(2):68-80.
The small joints of the hands and feet play a central role in the diagnosis and classification of arthropathy. Ultrasound can be used to assess involvement in areas that are clinically occult. The aim of this article was to review the current status of ultrasound imaging of patients with rheumatological disorders of the hands and feet. There is increasing evidence that ultrasound detects synovitis that is silent to clinical examination. Detection and classification of synovitis and the early detection of bone erosions are important in clinical decision making. Ultrasound has many advantages over other imaging techniques with which it is compared, particularly magnetic resonance. The ability to carry out a rapid assessment of many widely spacedjoints, coupled with clinical correlation, the ability to move and stress musculoskeletal structures and the use of ultrasound to guide therapy accurately are principal amongst these. The use of colour flow Doppler studies provides a measure of neovascularisation within the synovial lining of joints and tendons, and within tendons themselves, that is not available with other imaging techniques. Disadvantages compared to MRI include small field of view, poor image presentation, and difficulty in demonstrating cartilage and deep joints in their entirety.
手足的小关节在关节病的诊断和分类中起着核心作用。超声可用于评估临床上隐匿部位的受累情况。本文旨在综述手足风湿性疾病患者超声成像的现状。越来越多的证据表明，超声能检测出临床检查难以察觉的滑膜炎。滑膜炎的检测与分类以及骨侵蚀的早期发现对临床决策很重要。与其他成像技术（尤其是磁共振成像）相比，超声有许多优势。其中主要优势包括能够快速评估多个间距较大的关节，并与临床情况相关联，能够活动和施压肌肉骨骼结构，以及能够准确地利用超声引导治疗。彩色多普勒血流研究能够测量关节和肌腱滑膜衬里以及肌腱本身内的新生血管情况，这是其他成像技术所无法做到的。与磁共振成像相比，其缺点包括视野小、图像显示不佳以及难以完整显示软骨和深部关节。
