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关节软骨钙质沉着症的超声诊断。

Ultrasonographic diagnosis of articular chondrocalcinosis.

机构信息

Rheumatology and Rehabilitation Department, Minia University, Minia, Egypt.

出版信息

Rheumatol Int. 2012 Dec;32(12):3863-8. doi: 10.1007/s00296-011-2320-1. Epub 2011 Dec 23.

Abstract

To investigate the role of high-frequency ultrasonography in the diagnosis of calcium pyrophosphate dihydrate (CPPD) calcifications, in the most commonly affected joints in CPPD disease. Sixty patients with knee effusion were included in the study. All patients underwent musculoskeletal ultrasonography (on the shoulder, elbow, wrist, and knee joints), radiological examination of the sites examined by US, and synovial fluid analysis (using polarized light microscopy). Out of 60 patients with knee effusion, ultrasonographic calcifications (knees, shoulders, and wrists) were present in 38 patients (63.3%) and out of those patients; 32 had calcification characteristic of CPPD crystals deposition (hyperechoic deposits) in the knee and wrist joints. Pattern II (punctate pattern) was the most common pattern of calcification. It was present in all patients who had wrist calcification (18 patients) and in the knee in either alone (21 patients) or in association with pattern I (hyperechoic band) and/or pattern III (hyperechoic nodular or oval deposits) (9 patients). The sensitivity of ultrasonography for the detection of calcification was 84.2% while that of plain radiography was 13.2%, the specificity of both ultrasonography and plain radiography for the detection of calcification was 100%, and ultrasonography is valuable for diagnosing articular chondrocalcinosis via the detection of calcifications within the joint cartilage and fibrocartilage. Both sensitivity and specificity are high for detecting CPPD deposits.

摘要

为了研究高频超声在焦磷酸钙二水合物(CPPD)钙化中的诊断作用,本研究选择 CPPD 疾病中最常受累的关节。共纳入 60 例膝关节积液患者。所有患者均接受肌肉骨骼超声检查(肩、肘、腕和膝关节)、超声检查部位的放射学检查和关节滑液分析(偏振光显微镜)。在 60 例膝关节积液患者中,38 例(63.3%)患者超声检查可见钙化(膝关节、肩关节和腕关节),其中 32 例患者膝关节和腕关节存在 CPPD 晶体沉积特征性钙化(高回声沉积物)。II 型(点状模式)是最常见的钙化模式。18 例腕关节钙化患者均存在此模式,21 例膝关节单独存在此模式,9 例膝关节与 I 型(高回声带)和/或 III 型(高回声结节或椭圆形沉积物)同时存在此模式。超声检查检测钙化的灵敏度为 84.2%,普通 X 线摄影的灵敏度为 13.2%,超声检查和普通 X 线摄影检测钙化的特异性均为 100%,超声检查通过检测关节软骨和纤维软骨内的钙化,对关节软骨钙化的诊断具有重要价值。检测 CPPD 沉积物的敏感性和特异性均较高。

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