Department of Medicine and Medical Specialities, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico and Università degli Studi di Milano, Milan, Italy.
Haemophilia. 2012 May;18(3):364-8. doi: 10.1111/j.1365-2516.2011.02672.x. Epub 2011 Oct 17.
Imaging is an essential tool for evaluation and monitoring of haemophilic arthropathy. Ultrasonography is increasingly used for joint assessment, due to its great sensitivity for soft tissue and relatively low cost. To assess the joint status and the role of ultrasonography in routine diagnosis and monitoring of joint disease in cohort haemophilic patients. Findings of patients with haemophilia, who routinely underwent ultrasonography were retrospectively evaluated to assess their joint status and the role of ultrasonography in routine diagnosis and monitoring of joint disease. Out of 325 joints examined (115 ankles, 210 knees), ultrasonography identified damages in 50% of ankles and 33% of knees in overall 111 patients, aged 7-80 years (median = 29 years). Synovial hypertrophy and cartilage abnormalities were the most frequent observations (88% and 76% in affected knees, respectively). Pristine joints were more frequently found in patients on primary prophylaxis, young age or no bleeding in the year prior to examination. Furthermore, no concordance was found between presence of joint changes at ultrasonography, and clinical joint status. Ultrasonography was shown to be able to detect joint damage involving soft tissues and bone surface. Its use might allow frequent monitoring of patients with haemophilia and early detection of arthropathy. For these reasons it might represent a valid tool in the routine management of haemophilia.
影像学是评估和监测血友病性关节病的重要工具。由于超声对软组织具有很高的敏感性,且成本相对较低,因此越来越多地用于关节评估。评估队列血友病患者的关节状况以及超声在关节疾病常规诊断和监测中的作用。回顾性评估经常接受超声检查的血友病患者的检查结果,以评估其关节状况以及超声在关节疾病常规诊断和监测中的作用。在 325 个受检关节(115 个踝关节,210 个膝关节)中,111 名年龄为 7-80 岁(中位数= 29 岁)的患者中,超声检查发现 50%的踝关节和 33%的膝关节存在损伤。受影响的膝关节中,滑膜肥厚和软骨异常分别为最常见的观察结果(分别为 88%和 76%)。在接受初级预防、年龄较小或在检查前一年无出血的患者中,更常发现正常关节。此外,超声检查发现的关节变化与临床关节状况之间没有一致性。超声检查能够检测涉及软组织和骨表面的关节损伤。其使用可能允许频繁监测血友病患者并早期发现关节病。因此,它可能代表血友病常规管理中的有效工具。