Rheumatology Department, Cliniques Universitaires Saint-Luc, Pôle de recherche en rhumatologie, Institut de recherche expérimentale et clinique, Université catholique de Louvain, 1200 Brussels, Belgium.
Rheumatology (Oxford). 2013 Mar;52(3):529-33. doi: 10.1093/rheumatology/kes307. Epub 2012 Nov 28.
To assess the tendon and joint involvement at wrists and ankles of patients suffering from diffuse SSc and to identify the morphological substrate of tendon friction rubs (TFRs).
Fifteen consecutive patients suffering from diffuse SSc were included. All patients had two musculoskeletal US (MSUS) examinations of the wrists and ankles. MRI was performed at the most affected joints as detected by MSUS and in all sites in which TFRs were present.
No clinically overt arthritis or tenosynovitis was detected in the wrists and/or ankles prior to MSUS. Synovitis, tenosynovitis and tendon tear were identified in 8, 4 and 2 of 15 patients, respectively, by both MSUS and MRI. At entry, 5 patients had palpable TFRs (4 bilateral and 1 unilateral) and 10 patients did not. Tenosynovitis was more frequently found in ankles with TFRs (3/9) than in those without TFRs (3/21), although the difference was not statistically different (P = 0.3). Using MRI, deep connective tissue infiltrates surrounding tendons were present in all sites with TFRs but in only one patient without TFRs.
Both MSUS and MRI are effective in detecting synovitis and tenosynovitis in diffuse SSc patients. Tenosynovitis, synovitis and thickened retinacula are not infrequently seen in these patients. Our data suggest that juxta-tendinous connective tissue infiltrates might be the morphological substrate of tendon friction rubs, which may thus be a misnomer for tissue friction rubs.
评估患有弥漫性硬皮病的患者腕关节和踝关节的肌腱和关节受累情况，并确定肌腱摩擦音（TFR）的形态学基础。
纳入 15 例连续的弥漫性硬皮病患者。所有患者均进行了腕关节和踝关节的两次肌肉骨骼超声（MSUS）检查。在 MSUS 检测到最受影响的关节以及 TFR 存在的所有部位进行 MRI 检查。
在 MSUS 检查之前，腕关节和/或踝关节均未发现明显的关节炎或腱鞘炎。通过 MSUS 和 MRI 分别在 8、4 和 2 例患者中发现了滑膜炎、腱鞘炎和肌腱撕裂。在入组时，5 例患者有可触及的 TFR（4 例双侧，1 例单侧），10 例患者没有。在有 TFR 的踝关节（3/9）中更常发现腱鞘炎，而在没有 TFR 的踝关节中（3/21）则较少见，但差异无统计学意义（P = 0.3）。使用 MRI，在所有有 TFR 的部位均存在肌腱周围深部结缔组织浸润，但在无 TFR 的患者中仅 1 例存在。
MSUS 和 MRI 均可有效检测弥漫性硬皮病患者的滑膜炎和腱鞘炎。这些患者中常可见腱鞘炎、滑膜炎和增厚的支持带。我们的数据表明，肌腱旁结缔组织浸润可能是肌腱摩擦音的形态学基础，因此肌腱摩擦音可能是组织摩擦音的错误命名。
