Buosi Ana Letícia Pirozzi, Natour Jamil, Machado Flávia Soares, Takahashi Rogério D, Furtado Rita Nely Vilar
Rheumatology Division, Universidade Federal de São Paulo , São Paulo/SP , Brazil.
Mod Rheumatol. 2014 Jul;24(4):599-605. doi: 10.3109/14397595.2013.857583. Epub 2013 Dec 29.
To compare hand US between systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) patients.
Hands (1st-5th metacarpophalangeal [MCP] and 1st-5th proximal interphalangeal [PIP] joints) and wrists (radiocarpal and distal radioulnar joints) of 62 "no rhupus" SLE and 60 RA patients were compared through US (linear probe, 6-18 MHz). The findings were compared to clinical, functional, serological outcomes, and disease activity indices.
2108 and 2040 joint recesses were evaluated in SLE and AR patients, respectively. Synovitis was found in 46.8% and 75% of wrists, 83.9% and 86.7% of MCPs and 58.1% and 70% of PIPs in the SLE and RA groups, respectively. More significant US findings were found in RA group. Greater values of synovitis (mm) in RA group were only found in the joint recesses of wrist (p < 0.001-0.002). In SLE group, US findings were associated with "puffy hands," Health Assessment Questionnaire score and dynamometry. Twenty-two SLE patients (35.5%) had erosion in any of joints studied. SLE patient subgroup with US erosion was associated with hematological involvement and Jaccoud's arthropathy.
US of "no rhupus" SLE and RA patients is different, especially in wrists. In SLE patients the clinical variable most associated with US findings was "puffy hands."
比较系统性红斑狼疮（SLE）患者和类风湿关节炎（RA）患者手部的超声表现。
通过超声（线性探头，6 - 18 MHz）对62例“非rhupus”SLE患者和60例RA患者的手部（第1 - 5掌指关节[MCP]和第1 - 5近端指间关节[PIP]）及腕部（桡腕关节和桡尺远侧关节）进行检查。将检查结果与临床、功能、血清学结果及疾病活动指数进行比较。
分别对SLE患者和RA患者的2108个和2040个关节隐窝进行了评估。SLE组和RA组中，腕关节滑膜炎的发生率分别为46.8%和75%，MCP关节分别为83.9%和86.7%，PIP关节分别为58.1%和70%。RA组的超声表现更显著。RA组滑膜炎（mm）的更大值仅见于腕关节隐窝（p < 0.001 - 0.002）。在SLE组中，超声表现与“手部肿胀”、健康评估问卷评分及握力测定相关。22例SLE患者（35.5%）在所研究的任何关节中存在侵蚀。超声显示有侵蚀的SLE患者亚组与血液系统受累及Jaccoud关节病相关。
“非rhupus”SLE患者和RA患者的超声表现不同，尤其是在腕部。在SLE患者中，与超声表现最相关的临床变量是“手部肿胀”。
