Forney Michael C, Winalski Carl S, Schils Jean P
Section of Musculoskeletal Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
Top Magn Reson Imaging. 2011 Apr;22(2):45-59. doi: 10.1097/RMR.0b013e31825c008d.
As the treatment of inflammatory arthropathies has advanced with new therapies that can slow or even halt the development of disabling disease, early and accurate diagnosis has become imperative. Magnetic resonance (MR) imaging has proved to be very sensitive in the detection of erosions, but more importantly, it can demonstrate pre-erosive changes. Detection of synovitis and edema-like bone marrow lesions for initial diagnosis and as an indicator of disease progression can provide crucial information leading to therapeutic interventions before permanent joint damage occurs. Understanding the characteristic intra-articular and extra-articular MR imaging findings of the inflammatory arthritides allows the radiologist to provide appropriate consultations in the care of these patients. The MR appearances of both intra-articular and extra-articular findings of inflammatory arthritis are presented. Despite the advances in imaging, however, many of the MR findings remain nonspecific, and radiologists must avoid overdiagnosis by synthesizing all of the clinical information available into their interpretations.
随着炎症性关节病的治疗因新疗法的出现而取得进展，这些新疗法能够减缓甚至阻止致残性疾病的发展，早期准确诊断变得至关重要。磁共振（MR）成像已被证明在检测侵蚀方面非常敏感，但更重要的是，它能够显示侵蚀前的变化。检测滑膜炎和水肿样骨髓病变用于初始诊断以及作为疾病进展的指标，可以提供关键信息，从而在永久性关节损伤发生之前进行治疗干预。了解炎症性关节炎的关节内和关节外MR成像特征，有助于放射科医生在这些患者的护理中提供适当的会诊意见。本文介绍了炎症性关节炎的关节内和关节外表现。然而，尽管成像技术有所进步，但许多MR表现仍然是非特异性的，放射科医生必须通过将所有可用的临床信息综合到解读中，避免过度诊断。
