Department of Nuclear Medicine, Hanyang University Hospital, Seoul, Korea.
Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea.
J Korean Med Sci. 2014 Feb;29(2):204-9. doi: 10.3346/jkms.2014.29.2.204. Epub 2014 Jan 28.
We aimed to investigate the role of bone scintigraphy (BS) in the diagnosis of rheumatoid arthritis (RA) as a supplement to the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) criteria. A total of 156 patients who underwent BS with screening laboratory to confirm RA were enrolled. We divided them into two groups according to the presence of arthritis upon the first physical examination, and evaluated the diagnostic validity of BS as an independent (BS only) or assistant diagnostic tool using the 2010 criteria (BS-assisted). Seventy-five patients had active arthritis (Group I), while the remaining 81 patients did not (Group II). Among them, 56 patients in group I and 5 patients in group II were finally classified as RA. In the group I patients who were eligible for application of the 2010 criteria, the sensitivity of the BS only and BS-assisted diagnosis was not superior to that of the 2010 criteria. However, BS-assisted diagnosis showed high positive prediction values in group I patients with 2010 criteria score < 6 and group II patients. Therefore, BS is still helpful to detect RA even after the introduction of the 2010 criteria, especially among patients who do not satisfy the 2010 criteria as well as those who are ineligible for the 2010 criteria due to dubitable arthritis at clinical presentation.
我们旨在探讨骨闪烁扫描(BS)在类风湿关节炎(RA)诊断中的作用,作为 2010 年美国风湿病学会(ACR)/欧洲抗风湿病联盟(EULAR)标准的补充。共纳入了 156 例经 BS 检查且有筛选实验室检查以确诊 RA 的患者。我们根据首次体格检查时是否有关节炎,将他们分为两组,并使用 2010 标准评估 BS 作为独立(仅 BS)或辅助诊断工具的诊断有效性(BS 辅助)。75 例患者有关节炎(I 组),其余 81 例患者没有(II 组)。其中,I 组中 56 例患者和 II 组中 5 例患者最终被确诊为 RA。在符合 2010 标准应用条件的 I 组患者中,仅 BS 和 BS 辅助诊断的敏感性并不优于 2010 标准。然而,BS 辅助诊断在 2010 标准评分<6 的 I 组患者和 II 组患者中具有较高的阳性预测值。因此,即使在引入 2010 标准后,BS 仍然有助于检测 RA,尤其是在那些不符合 2010 标准的患者以及由于临床表现可疑关节炎而不适合 2010 标准的患者中。