Ohrndorf S, Halbauer B, Martus P, Reiche B, Backhaus T M, Burmester G R, Backhaus M
Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany.
Int J Rheumatol. 2013;2013:493848. doi: 10.1155/2013/493848. Epub 2013 Aug 12.
Objective. The main objective of this study was to evaluate the 7-joint ultrasound (US7) score by detailed joint region analysis of an arthritis patient cohort. Methods. The US7 score examines the clinically most affected wrist, MCP and PIP II, III, MTP II, and V joints for synovitis, tenosynovitis/paratenonitis, and erosions. Forty-five patients with rheumatoid arthritis (RA) (84.4%) and spondyloarthritis with polyarticular peripheral arthritis (PsA 13.3%; AS 2.2%) with a median disease duration of 6.5 yrs (range 7.5 mths-47.6 yrs) were included and examined at baseline and 3, 6, and 12 months after starting or changing therapy (DMARD/biologic). In this study, detailed US7 score joint region analysis was firstly performed. Results. The joint region analysis performed at baseline disclosed synovitis in 95.6% of affected wrists in the dorsal aspect by greyscale (GS) US where Grade 2 (moderate) was most often (48.9%) detected. Palmar wrist regions presented Grade 1 (minor) capsule elevation in 40% and Grade 2 (moderate synovitis) in 37.8%. Tenosynovitis of the extensor carpi ulnaris (ECU) tendon was found in 40%, with PD activity in 6.6%. Most of the erosions in MCP II were detected in the radial (68.9%), followed by the dorsal (48.9%) and palmar (44.4%) aspects. In MTP V, erosions were seen in 75.6% from lateral. Conclusions. Synovitis in GSUS was more often detected in the wrist in the dorsal than in the palmar aspect. ECU tendon involvement was frequent. Most erosions were found in the lateral scan of MTP V and the medial (radial) scan of MCP II.
目的。本研究的主要目的是通过对关节炎患者队列进行详细的关节区域分析来评估七关节超声（US7）评分。方法。US7评分检查临床上受累最严重的腕关节、掌指关节（MCP）和近端指间关节（PIP）的Ⅱ、Ⅲ关节、跖趾关节（MTP）的Ⅱ和Ⅴ关节，以评估滑膜炎、腱鞘炎/腱周组织炎和骨侵蚀情况。纳入45例类风湿关节炎（RA）患者（84.4%）和多关节外周关节炎的脊柱关节炎患者（银屑病关节炎（PsA）13.3%；强直性脊柱炎（AS）2.2%），疾病中位病程为6.5年（范围7.5个月 - 47.6年），在开始或改变治疗（改善病情抗风湿药/生物制剂）后的基线、3个月、6个月和12个月进行检查。在本研究中，首先进行了详细的US7评分关节区域分析。结果。基线时进行的关节区域分析显示，在灰阶（GS）超声检查中，95.6%的受累腕关节背侧存在滑膜炎，其中最常检测到的是2级（中度）（48.9%）。腕关节掌侧区域40%出现1级（轻度）关节囊抬高，37.8%出现2级（中度滑膜炎）。尺侧腕伸肌（ECU）肌腱腱鞘炎的发生率为40%，其中6.6%有能量多普勒（PD）活动。MCPⅡ关节的大多数骨侵蚀在桡侧（68.9%）被检测到，其次是背侧（48.9%）和掌侧（44.4%）。在MTPⅤ关节，75.6%的骨侵蚀出现在外侧。结论。GS超声检查发现腕关节滑膜炎在背侧比掌侧更常见。ECU肌腱受累频繁。大多数骨侵蚀出现在MTPⅤ关节的外侧扫描和MCPⅡ关节的内侧（桡侧）扫描中。
